Provider Demographics
NPI:1225181670
Name:R B WATSON PHARMACY INC
Entity Type:Organization
Organization Name:R B WATSON PHARMACY INC
Other - Org Name:WATSONS PHARNACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-635-4568
Mailing Address - Street 1:16 W WALL ST.
Mailing Address - Street 2:
Mailing Address - City:FROSTPROOF
Mailing Address - State:FL
Mailing Address - Zip Code:33843
Mailing Address - Country:US
Mailing Address - Phone:863-635-4568
Mailing Address - Fax:863-635-2831
Practice Address - Street 1:16 W WALL ST.
Practice Address - Street 2:
Practice Address - City:FROSTPROOF
Practice Address - State:FL
Practice Address - Zip Code:33843
Practice Address - Country:US
Practice Address - Phone:863-635-4568
Practice Address - Fax:863-635-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS7176333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0614060001Medicare NSC