Provider Demographics
NPI:1285025726
Name:TUTELA RX LLC
Entity Type:Organization
Organization Name:TUTELA RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOFFSINGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:D PH
Authorized Official - Phone:888-385-5973
Mailing Address - Street 1:619 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4104
Mailing Address - Country:US
Mailing Address - Phone:888-385-5973
Mailing Address - Fax:855-744-6439
Practice Address - Street 1:1419 KENSINGTON SQUARE CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-6939
Practice Address - Country:US
Practice Address - Phone:888-385-5973
Practice Address - Fax:855-744-6439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH288663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH28866OtherFLORIDA BOARD OF PHARMACY