Organization
FATHER DAVID LLC
Active
Other names
Maxcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBA NATHAN PHARMD (PHARMACIST OWNER)
(727) 807-7050
Entity
Organization
Contact information
Practice address
6624 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-1739
(727) 807-7050
(727) 807-6050
Mailing address
6624 US HIGHWAY 19, NEW PORT RICHEY, FL 34652-1739
(727) 807-7050
(727) 807-6050
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25823
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00545480
—
FL
05
—
005454800
—
FL
01
—
2133922
PK
—
Enumeration date
02/23/2012
Last updated
05/06/2021
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