Provider Demographics
NPI:1124142567
Name:DRUG DEPOT INC
Entity type:Organization
Organization Name:DRUG DEPOT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-547-2654
Mailing Address - Street 1:2595 TAMPA RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3152
Mailing Address - Country:US
Mailing Address - Phone:727-547-2654
Mailing Address - Fax:727-541-6444
Practice Address - Street 1:2595 TAMPA RD
Practice Address - Street 2:SUITE E
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3152
Practice Address - Country:US
Practice Address - Phone:727-547-2654
Practice Address - Fax:727-541-6444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPPH209863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1009340OtherNCPD