Provider Demographics
NPI:1548560725
Name:PAS RX LLC
Entity Type:Organization
Organization Name:PAS RX LLC
Other - Org Name:HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PARAG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-857-6286
Mailing Address - Street 1:2224 STATE ROAD 60 E
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-3703
Mailing Address - Country:US
Mailing Address - Phone:813-681-7800
Mailing Address - Fax:813-681-7833
Practice Address - Street 1:2224 STATE ROAD 60 E
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-3703
Practice Address - Country:US
Practice Address - Phone:813-681-7800
Practice Address - Fax:813-681-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH249813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5702697OtherNCPDP PROVIDER IDENTIFICATION NUMBER