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Organization

MY PHARMACY OF BIG BEND, INC.

Active
Other names
My Pharmacy of Big Bend
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATHEW RYAN GONZALES (PRESIDENT)
(813) 699-3496
Entity
Organization

Contact information

Practice address
538 WILBUR ST, BRANDON, FL 33511-5324
(813) 699-3496
(813) 699-5190
Mailing address
538 WILBUR ST, BRANDON, FL 33511-5324
(813) 699-3496
(813) 699-5190

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009863500
FL
Enumeration date
07/25/2013
Last updated
04/17/2020
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