Provider Demographics
NPI:1124387337
Name:PHARMACHOICE INC
Entity Type:Organization
Organization Name:PHARMACHOICE INC
Other - Org Name:PHARMACHOICE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-207-9395
Mailing Address - Street 1:8019 RIDGE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-7039
Mailing Address - Country:US
Mailing Address - Phone:727-378-8581
Mailing Address - Fax:
Practice Address - Street 1:6045 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5039
Practice Address - Country:US
Practice Address - Phone:305-418-0046
Practice Address - Fax:305-456-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336M0002X
FLPH261173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135099OtherPK