Organization
PRIME CARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENKATESHWARLU THAUDBOINA (AGENT)
(352) 600-8083
Entity
Organization
Contact information
Practice address
2176 MARINER BLVD, SPRING HILL, FL 34609-3859
(352) 600-8083
(352) 600-7033
Mailing address
2176 MARINER BLVD, SPRING HILL, FL 34609-3859
(352) 684-8477
(352) 684-6877
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH33260
PHARMACY STATE LICENSE
FL
Enumeration date
05/03/2021
Last updated
05/03/2021
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