Organization
ST LUKE PHARMACY CORP
Active
Organization
ST LUKE PHARMACY CORP
Active
Other names
ST Luke Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MUSALLAM (PRESIDENT)
(727) 754-7851
Entity
Organization
Contact information
Practice address
2019 GULF TO BAY BLVD, CLEARWATER, FL 33765-3703
(727) 754-7851
(727) 754-7852
Mailing address
2019 GULF TO BAY BLVD, CLEARWATER, FL 33765-3703
(727) 754-7851
(727) 754-7852
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008099500
—
FL
01
—
2135137
PK
—
Enumeration date
05/11/2012
Last updated
07/13/2015
Update your record
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