Organization
M&S PHARMACY LLC
Active
Other names
Champions Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAIKEL BOLOS PHARM D (PHARMACIST)
(813) 205-3670
Entity
Organization
Contact information
Practice address
9945 TRINITY BLVD STE 108, TRINITY, FL 34655-4552
(727) 372-2200
Mailing address
9945 TRINITY BLVD STE 108, TRINITY, FL 34655-4552
(727) 372-2200
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PH25314
FL
Other
Enumeration date
04/18/2011
Last updated
04/19/2011
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