Provider Information for 1558817783
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PLAMYRA PHARMACY LLC
Organization Subpart: NO
NPI: 1558817783
Last Updated: 2016-08-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1558817783 | ||||||||
| Enumeration Date | 2016-08-28 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: MOHAB HARAKA Title: Manager Phone: 3522133815 | ||||||||
| Mailing Address | 4817 E BUSCH BLVD TAMPA, FL 33617 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 4817 E BUSCH BLVD TAMPA, FL 33617 United States Phone: 352-213-3815 | Fax: | ||||||||
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