Provider Demographics
NPI:1114661741
Name:MEDICA PHARMACY
Entity Type:Organization
Organization Name:MEDICA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKRITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:407-554-5010
Mailing Address - Street 1:105 COMMERCE ST STE 109
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6228
Mailing Address - Country:US
Mailing Address - Phone:407-554-5010
Mailing Address - Fax:407-554-5027
Practice Address - Street 1:105 COMMERCE ST STE 109
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6228
Practice Address - Country:US
Practice Address - Phone:407-554-5010
Practice Address - Fax:407-554-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy