Organization
SOUTHCARE PHARMACY INC.
Active
Other names
Southcare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY BRAND (OWNER)
(727) 344-3902
Entity
Organization
Contact information
Practice address
6450 38TH AVE N STE A1, SAINT PETERSBURG, FL 33710-1645
(727) 344-3902
(727) 343-1356
Mailing address
PO BOX 580, MCDONOUGH, GA 30253-0580
(770) 474-7693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH25055
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003481800
—
FL
01
—
2160733
PK
—
Enumeration date
06/23/2016
Last updated
01/17/2025
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