Organization
SA DRUGS LLC
Active
Other names
CITY DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
RAJASEKARAN MANI (MANAGER)
(239) 246-0796
Entity
Organization
Contact information
Practice address
115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643-4301
(386) 454-7768
Mailing address
13207 THOMASVILLE CIR APT D, TAMPA, FL 33617-9507
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25943
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005462300
—
FL
01
—
5709172
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/21/2012
Last updated
03/13/2013
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