Provider Demographics
NPI:1194881599
Name:S & S PHARMACY INC
Entity type:Organization
Organization Name:S & S PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PHCY MGR
Authorized Official - Prefix:
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSOUM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-766-9955
Mailing Address - Street 1:14973 BRUCE B DOWNS BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613
Mailing Address - Country:US
Mailing Address - Phone:813-866-5000
Mailing Address - Fax:813-866-5001
Practice Address - Street 1:14973 BRUCE B DOWNS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2860
Practice Address - Country:US
Practice Address - Phone:813-866-5000
Practice Address - Fax:813-866-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
FLPH224473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023984OtherNCPDP PROVIDER IDENTIFICATION NUMBER