1619965746 NPI number — MR. WILLIAM E POLLARD RPH

Table of content: MR. WILLIAM E POLLARD RPH (NPI 1619965746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619965746 NPI number — MR. WILLIAM E POLLARD RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POLLARD
Provider First Name:
WILLIAM
Provider Middle Name:
E
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1619965746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3819
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAY PINES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33744-3819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-398-6661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10000 BAY PINES BLVD
Provider Second Line Business Practice Location Address:
PHARMACY SERVICE (119)
Provider Business Practice Location Address City Name:
ST. PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-398-6661
Provider Business Practice Location Address Fax Number:
727-398-9506
Provider Enumeration Date:
10/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PS 16084 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: RPH015232 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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