Provider Demographics
NPI:1487170148
Name:TRUST PHARMACY LTC ,LLC
Entity type:Organization
Organization Name:TRUST PHARMACY LTC ,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-223-3464
Mailing Address - Street 1:36511 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1340
Mailing Address - Country:US
Mailing Address - Phone:727-781-7400
Mailing Address - Fax:727-781-7433
Practice Address - Street 1:36511 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1340
Practice Address - Country:US
Practice Address - Phone:727-781-7400
Practice Address - Fax:727-781-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy