Provider Demographics
NPI:1285871236
Name:R & GRIFFITH ENTERPRISE INC
Entity type:Organization
Organization Name:R & GRIFFITH ENTERPRISE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RETS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-334-8946
Mailing Address - Street 1:10859 CORY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2992
Mailing Address - Country:US
Mailing Address - Phone:813-865-0522
Mailing Address - Fax:813-865-0524
Practice Address - Street 1:2912 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1855
Practice Address - Country:US
Practice Address - Phone:813-865-0522
Practice Address - Fax:813-865-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH237193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1041350OtherNCPDP PROVIDER IDENTIFICATION NUMBER