1316261035 NPI number — ALPHA DRUG INC

Table of content: (NPI 1316261035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316261035 NPI number — ALPHA DRUG INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA DRUG INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALPHA DRUGS INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316261035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1450 OAKFIELD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33511-4853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-685-5454
Provider Business Mailing Address Fax Number:
813-685-2292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1450 OAKFIELD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33511-4853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-685-5454
Provider Business Practice Location Address Fax Number:
813-685-2292
Provider Enumeration Date:
03/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
ALIMI
Authorized Official First Name:
TAJUDEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY MANAGER
Authorized Official Telephone Number:
813-350-9484

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PH24498 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1056818 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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