Organization
CALLAWAY GULF COAST PHARMACY CO
Active
Other names
CALLAWAY GULF COAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL EBRAHIM (PRESIDENT)
(850) 319-3238
Entity
Organization
Contact information
Practice address
420 N TYNDALL PKWY, PANAMA CITY, FL 32404-6125
(850) 615-2000
Mailing address
420 N TYNDALL PKWY, PANAMA CITY, FL 32404-6125
(850) 615-2000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH29076
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151701
PK
—
Enumeration date
05/04/2015
Last updated
02/04/2021
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