Organization
SOUTHSHORE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A FLAX (OWNER)
(863) 712-3064
Entity
Organization
Contact information
Practice address
13127 KINGS LAKE DR., UNIT 102, GIBSONTON, FL 33534-3958
(813) 672-9600
(813) 613-1968
Mailing address
13127 KINGS LAKE DR., UNIT 102, GIBSONTON, FL 33534-3958
(813) 672-9600
(813) 613-1968
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
10/21/2014
Last updated
09/11/2015
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