Organization
ELLENTON DISCOUNT PHARMACY LLC
Active
Other names
ELLENTON DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KUNJAL PATEL (PHARMACIST)
(941) 444-2233
Entity
Organization
Contact information
Practice address
8324 US HIGHWAY 301 N, PARRISH, FL 34219-8653
(941) 444-2233
(941) 417-7144
Mailing address
8324 US HIGHWAY 301 N, PARRISH, FL 34219-8653
(941) 444-2233
(941) 417-7144
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH29831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017320800
—
FL
01
—
2175537
PK
—
Enumeration date
09/13/2017
Last updated
07/19/2018
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