Provider Demographics
NPI:1568505089
Name:CANTONMENT PHARMACY INC
Entity Type:Organization
Organization Name:CANTONMENT PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:READING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-968-9992
Mailing Address - Street 1:433 S HIGHWAY 29
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-1401
Mailing Address - Country:US
Mailing Address - Phone:850-968-9992
Mailing Address - Fax:
Practice Address - Street 1:433 S HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:CANTONMENT
Practice Address - State:FL
Practice Address - Zip Code:32533-1401
Practice Address - Country:US
Practice Address - Phone:850-968-9992
Practice Address - Fax:850-968-0459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH10065332B00000X, 333600000X
FLPH2748333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102398500Medicaid
FL102398500Medicaid
AC5573769OtherFEDERAL DEA REGISTRATION
FL102398500Medicaid