Organization
UMBRA INC
Active
Other names
4th St Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCIS ENERIO (PRESIDENT)
(813) 476-0854
Entity
Organization
Contact information
Practice address
5415 4TH ST N, ST PETERSBURG, FL 33703-2249
(727) 329-8798
(727) 329-8800
Mailing address
5415 4TH ST N, ST PETERSBURG, FL 33703-2249
(727) 329-8798
(727) 329-8800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH23991
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001669500106
—
FL
01
—
2119880
PK
—
Enumeration date
04/03/2009
Last updated
08/22/2016
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