Organization
PEPPER TREE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL AYOTUNDE (PHARMACY MANAGER)
(352) 622-5601
Entity
Organization
Contact information
Practice address
1907 SE 58TH AVE, ROLLING GREENS SHOPPING CENTER, OCALA, FL 34480-5847
(352) 622-5601
(352) 622-5612
Mailing address
1907 SE 58TH AVE, ROLLING GREENS SHOPPING CENTER, OCALA, FL 34480-5847
(352) 622-5601
(352) 622-5612
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03129600
—
FL
01
—
PH 25060
PHARMACY LICENSE #
FL
Enumeration date
10/18/2010
Last updated
10/25/2013
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