Organization
VISTA SPECIALTY PHARMACY
Active
Other names
Vista Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MEYYAPPAN RAMANATHAN (DIRECTOR OF PHARMACY)
(570) 341-5728
Entity
Organization
Contact information
Practice address
235 W HIGHWAY 50, CLERMONT, FL 34711-3027
(352) 241-6293
(352) 989-5849
Mailing address
235 W HWY 50, CLERMONT, FL 34711-3027
(352) 241-6293
(352) 989-5849
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PH27256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143187
PK
—
Enumeration date
12/04/2013
Last updated
03/03/2016
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