Organization
AGIOS CORP
Active
Organization
AGIOS CORP
Active
Other names
St. Mary Pharmacy, Compounding and Medical Supply, St. Mary Pharmacy Compounding and Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN O MANSOUR PHARMD (CEO)
(352) 357-6699
Entity
Organization
Contact information
Practice address
1314 S BAY ST, EUSTIS, FL 32726-5551
(352) 357-6699
(352) 357-2390
Mailing address
1314 S BAY ST, EUSTIS, FL 32726-5551
(352) 357-6699
(352) 357-2390
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH30203
FL
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
08/23/2016
Last updated
03/17/2026
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