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Organization

VISTA SPECILTY PHARMACY

Active
Other names
Key Health Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
SANDEEP MATHOW (DIRECTOR OF PHARMACY)
(407) 536-5696
Entity
Organization

Contact information

Practice address
1500 OAKLEY SEAVER DR STE 3, CLERMONT, FL 34711-1974
(352) 989-5850
(352) 989-5849
Mailing address
1500 OAKLEY SEAVER DR STE 3, CLERMONT, FL 34711-1974
(352) 989-5850
(352) 989-5849

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PH28734
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2149428
PK
Enumeration date
07/19/2012
Last updated
06/23/2016
About Stedi
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  • EDI platform