Organization
PHARMLAND, LLC
Active
Other names
Lifecare Pharmacy Long term Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS JUAN MAZARIEGOS PHARMD (CO-OWNER)
(727) 209-1283
Entity
Organization
Contact information
Practice address
3426 13TH AVE N, SUITE B, ST PETERSBURG, FL 33713-5424
(727) 209-1283
(727) 209-1281
Mailing address
3426 13TH AVE N, SUITE B, ST PETERSBURG, FL 33713-5424
(727) 209-1283
(727) 209-1281
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH24967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000609300
—
FL
Enumeration date
10/27/2010
Last updated
10/27/2010
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