Provider Demographics
NPI:1174282529
Name:TITA PHARMA LLC
Entity Type:Organization
Organization Name:TITA PHARMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:NJI
Authorized Official - Last Name:TITA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:813-371-9898
Mailing Address - Street 1:2705 54TH AVE N STE 1
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-1940
Mailing Address - Country:US
Mailing Address - Phone:727-371-9898
Mailing Address - Fax:727-290-4324
Practice Address - Street 1:2705 54TH AVE N STE 1
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-1940
Practice Address - Country:US
Practice Address - Phone:727-371-9898
Practice Address - Fax:727-290-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy