Vistara Specialty Pharmacy

LBN: Eckerds Pharmacy Llc
Vistara Specialty Pharmacy is an health care organization with primary practice located at 4404 66Th St N , Kenneth City FL 33709-4922. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Eckerds Pharmacy Llc can be contacted via phone (727) 513-1107, or through Patel, Bhaveshkumar via phone (813) 900-4995.

Contact Information

Primary practice address
4404 66Th St N Kenneth City FL 33709-4922
Phone: (727) 513-1107
Fax: (727) 513-1109
Website:
Map and Directions
Authorized official contact:
Name: Patel, Bhaveshkumar
Phone: (813) 900-4995

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1922577832
LBN Legal business name Eckerds Pharmacy Llc
DBA Doing business as Vistara Specialty Pharmacy
Authorized official Patel, Bhaveshkumar
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2018
Last updated Jan 18th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922577832 NPPES
Florida Other PH31757 LICENSE
Florida MEDICAID 101899100 LICENSE

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