Organization
TRADELINE SH INC
Active
Other names
Logos Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAAFAT HABIB (PRESIDENT/OWNER)
(248) 631-6565
Entity
Organization
Contact information
Practice address
7543 W WATERS AVE, TAMPA, FL 33615-1511
(813) 886-2800
(813) 886-2822
Mailing address
7543 W WATERS AVE, TAMPA, FL 33615-1511
(813) 886-2800
(813) 886-2822
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29105
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015407500
—
FL
01
—
2151298
PK
—
Enumeration date
04/07/2015
Last updated
08/18/2020
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