Organization
ST GEORGE PHARMACY INC
Active
Other names
ST GEORGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SHADY ABDELMASIH (PHARMACY MGR)
(727) 772-6868
Entity
Organization
Contact information
Practice address
31201 US HIGHWAY 19 N, PALM HARBOR, FL 34684-4480
(727) 772-6868
(727) 772-6969
Mailing address
31201 US HIGHWAY 19 N, PALM HARBOR, FL 34684-4480
(727) 772-6868
(727) 772-6969
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH18889
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025840700
—
FL
01
—
2015172
PK
—
Enumeration date
12/18/2006
Last updated
07/02/2013
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