Organization
CALLAWAY GULF COAST PHARMACY CO
Active
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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