Provider Demographics
NPI:1568532679
Name:BILL'S PRESCRIPTION CENTER, INC.
Entity Type:Organization
Organization Name:BILL'S PRESCRIPTION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BEATTIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:813-689-3521
Mailing Address - Street 1:202 E BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5221
Mailing Address - Country:US
Mailing Address - Phone:813-689-3521
Mailing Address - Fax:813-681-8475
Practice Address - Street 1:202 E BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5221
Practice Address - Country:US
Practice Address - Phone:813-689-3521
Practice Address - Fax:813-681-8475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH00025673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103736602OtherDME
FL103736600Medicaid
FL103736600Medicaid