Organization
MEDLINE ENTERPRISES INC
Active
Other names
PASADENA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KING YEOTAN (PRESIDENT)
(727) 344-5151
Entity
Organization
Contact information
Practice address
1206 PASADENA AVE S, SOUTH PASADENA, FL 33707-6202
(727) 344-5151
(727) 489-9489
Mailing address
PO BOX 55632, ST PETERSBURG, FL 33732-5632
(813) 494-0458
(727) 489-9489
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH24282
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049926
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/26/2009
Last updated
04/06/2010
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