Organization
HARBOUR ISLAND SPECIALTY PHARMACY
Active
Other names
Harbour Island Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY PRIETO (OWNER)
(813) 925-0300
Entity
Organization
Contact information
Practice address
12615 RACE TRACK RD, TAMPA, FL 33626-1331
(813) 925-0300
(813) 925-0311
Mailing address
12615 RACE TRACK RD, TAMPA, FL 33626-1331
(813) 925-0300
(813) 925-0311
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH24548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055309
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/06/2010
Last updated
10/06/2011
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