Organization
ONE SOURCE PHARMACY OF BRADENTON
Active
Parent organization
ONE SOURCE PHARMACY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONE SOURCE PHARMACY, LLC
Authorized official
INDRAJIT VYAS (OWNER/MGR)
(877) 490-8987
Entity
Organization
Contact information
Practice address
3501 CORTEZ RD W, UNIT 901B, BRADENTON, FL 34210
(877) 490-8987
(877) 490-8987
Mailing address
6404 OLD WINTER GARDEN RD, ORLANDO, FL 32835-1348
(877) 490-8987
(877) 490-8987
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25399
FL
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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