Provider Demographics
NPI:1275086787
Name:PHAROS MANAGEMENT GROUP
Entity Type:Organization
Organization Name:PHAROS MANAGEMENT GROUP
Other - Org Name:PHARMACO MEDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DELMADOROS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:727-754-9497
Mailing Address - Street 1:1003 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-4438
Mailing Address - Country:US
Mailing Address - Phone:727-754-9497
Mailing Address - Fax:727-281-4444
Practice Address - Street 1:1003 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-4438
Practice Address - Country:US
Practice Address - Phone:727-754-9497
Practice Address - Fax:727-281-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH30207333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022067000Medicaid