Organization
ECKERDS PHARMACY LLC
Active
Parent organization
ECKERDS PHARMACY LLC
Other names
VISTARA SPECIALTY PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ECKERDS PHARMACY LLC
Authorized official
BHAVESHKUMAR PATEL (AUTHORIZED OFFICER)
(813) 900-4995
Entity
Organization
Contact information
Practice address
4404 66TH ST N, KENNETH CITY, FL 33709-4922
(727) 513-1107
(727) 513-1109
Mailing address
4404 66TH ST N, KENNETH CITY, FL 33709-4922
(727) 513-1107
(727) 513-1109
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101899100
—
FL
Enumeration date
03/10/2020
Last updated
01/18/2024
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