Organization
ZEPHYRHILLS COMMUNITY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR DHADUK (OWNER)
(201) 916-7123
Entity
Organization
Contact information
Practice address
6242 GALL BLVD, ZEPHYRHILLS, FL 33542-2505
(813) 395-6161
(866) 991-4552
Mailing address
4040 SUNSET LAKE DR, LAKELAND, FL 33810
(201) 916-7123
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169992
PK
—
Enumeration date
06/21/2017
Last updated
11/30/2020
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