Provider Demographics
NPI:1225641525
Name:ENGLEWOOD PHARMACEUTICAL SERVICES INC
Entity Type:Organization
Organization Name:ENGLEWOOD PHARMACEUTICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BISHOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-877-8753
Mailing Address - Street 1:4057 CROCKERS LAKE BLVD APT 2511
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5319
Mailing Address - Country:US
Mailing Address - Phone:941-877-8753
Mailing Address - Fax:
Practice Address - Street 1:1720 S MCCALL RD STE J
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4867
Practice Address - Country:US
Practice Address - Phone:941-877-8753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy