Provider Demographics
NPI:1346565645
Name:CK PHARMA
Entity Type:Organization
Organization Name:CK PHARMA
Other - Org Name:ANCLOTE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-410-3791
Mailing Address - Street 1:1933 N PINELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5780
Mailing Address - Country:US
Mailing Address - Phone:727-944-5800
Mailing Address - Fax:727-944-5844
Practice Address - Street 1:1933 N PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5780
Practice Address - Country:US
Practice Address - Phone:727-944-5800
Practice Address - Fax:727-944-5844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH244893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy