Organization
SUPER SAVER PHARMACY #NO 2 LLC
Active
Other names
SUPER SAVER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DEVAN MATHURA (OWNER)
(407) 343-1230
Entity
Organization
Contact information
Practice address
200 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0765
(407) 846-0738
Mailing address
2701 MICHIGAN AVE, KISSIMMEE, FL 34744-1214
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH21929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018692
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
05/23/2006
Last updated
08/22/2020
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