Organization
ORANGE-BAY PHARMACY LLC
Active
Other names
ORANGE BAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LANRE OKUSANYA PHRMD (CO OWNER)
(412) 996-2266
Entity
Organization
Contact information
Practice address
4625 N NEBRASKA AVE, TAMPA, FL 33603-4013
(813) 418-6780
(813) 238-0237
Mailing address
4625 N NEBRASKA AVE, TAMPA, FL 33603-4013
(813) 418-6780
(813) 238-0237
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23400
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005573
PK
—
05
—
426700
—
FL
Enumeration date
10/30/2007
Last updated
09/24/2021
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