Organization
5M PHARMA LLC
Active
Other names
Spectrum Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
VIRAL SHAH (OWNER/PHARMACIST IN CHARGE)
(813) 968-9100
Entity
Organization
Contact information
Practice address
6056 VAN DYKE RD, LUTZ, FL 33558-8000
(813) 968-9100
(813) 968-9200
Mailing address
6056 VAN DYKE RD, LUTZ, FL 33558-8000
(813) 968-9100
(813) 968-9200
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008444000
—
FL
01
—
2137240
PK
—
Enumeration date
10/03/2012
Last updated
11/24/2014
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