Provider Demographics
NPI:1982678918
Name:UGALAND INC
Entity type:Organization
Organization Name:UGALAND INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MGR
Authorized Official - Prefix:
Authorized Official - First Name:HAKEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:FASHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:813-500-8280
Mailing Address - Street 1:PO BOX 46725
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-0107
Mailing Address - Country:US
Mailing Address - Phone:813-915-5022
Mailing Address - Fax:813-915-5021
Practice Address - Street 1:4700 N HABANA AVE STE 502
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7120
Practice Address - Country:US
Practice Address - Phone:813-915-5022
Practice Address - Fax:813-915-5021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH197503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2006609OtherPK
FL026597700Medicaid