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Organization

HOMETOWN OLD COUNTRY PHARMACY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SATVIK THAKKAR (MANAGEMENT MEMBER)
(727) 816-9770
Entity
Organization

Contact information

Practice address
8534 RIDGE ROAD, NEW PORT RICKEY, FL 34654
(727) 816-9770
(727) 817-1310
Mailing address
8534 RIDGE ROAD, NEW PORT RICKEY, FL 34654
(727) 816-9770
(727) 817-1310

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002228400
FL
05
120435900
FL
Enumeration date
09/15/2005
Last updated
03/06/2024
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