Provider Demographics
NPI:1326348921
Name:ORLANDO DISCOUNT PHARMACY INC
Entity Type:Organization
Organization Name:ORLANDO DISCOUNT PHARMACY INC
Other - Org Name:ORLANDO DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRAV
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:407-412-6912
Mailing Address - Street 1:419 E MICHIGAN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4511
Mailing Address - Country:US
Mailing Address - Phone:407-412-6912
Mailing Address - Fax:407-412-6913
Practice Address - Street 1:419 E MICHIGAN ST STE 4
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4511
Practice Address - Country:US
Practice Address - Phone:407-412-6912
Practice Address - Fax:407-412-6913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
FLPH249843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5702267OtherNCPDP PROVIDER IDENTIFICATION NUMBER