Provider Demographics
NPI:1518554856
Name:SRQ CARE PHARMACY INC
Entity Type:Organization
Organization Name:SRQ CARE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE / CEO
Authorized Official - Prefix:
Authorized Official - First Name:YELYZAVETA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMUROVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD RPH
Authorized Official - Phone:941-759-1000
Mailing Address - Street 1:4201 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3627
Mailing Address - Country:US
Mailing Address - Phone:941-750-1000
Mailing Address - Fax:
Practice Address - Street 1:4201 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3627
Practice Address - Country:US
Practice Address - Phone:941-750-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH33086OtherFLORIDA STATE BOARD OF PHARMACY