Organization
LUTZ PHARMACY LLC
Active
Other names
Lutz Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAIMIN TAKTAWALA RPH (OWNER)
(813) 948-4500
Entity
Organization
Contact information
Practice address
1930 LAND O LAKES BLVD, STE 15, LUTZ, FL 33549-2999
(813) 948-4500
(813) 948-0400
Mailing address
1930 LAND O LAKES BLVD, STE 15, LUTZ, FL 33549-2999
(813) 948-4500
(813) 948-0400
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053038
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/02/2010
Last updated
09/23/2024
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