Organization
DUTTA LLC
Active
Other names
HEALTHMED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VISHAL MALKAN (MANAGING MEMBER)
(813) 285-9365
Entity
Organization
Contact information
Practice address
1839 CENTRAL AVE, SAINT PETERSBURG, FL 33713-8900
(727) 894-3001
(727) 894-3000
Mailing address
1839 CENTRAL AVE, U 101, SAINT PETERSBURG, FL 33713-8900
(727) 894-3001
(727) 894-3000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001304900
—
FL
01
—
2120787
PK
—
Enumeration date
06/24/2009
Last updated
01/20/2017
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