Provider Demographics
NPI:1598362519
Name:FAST & FRIENDLY LTC PHARMACY, LLC
Entity Type:Organization
Organization Name:FAST & FRIENDLY LTC PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAIDEE
Authorized Official - Middle Name:PRENIL
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:813-704-6857
Mailing Address - Street 1:3202 W BAKER ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-2849
Mailing Address - Country:US
Mailing Address - Phone:813-704-6857
Mailing Address - Fax:813-756-6938
Practice Address - Street 1:3202 W BAKER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-2849
Practice Address - Country:US
Practice Address - Phone:813-704-6857
Practice Address - Fax:813-756-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy