Provider Demographics
NPI:1629371679
Name:PAPPY'S DRUGS, INC
Entity Type:Organization
Organization Name:PAPPY'S DRUGS, INC
Other - Org Name:PRIMA VISTA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUBINO-UHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-233-8374
Mailing Address - Street 1:889A E PRIMA VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952
Mailing Address - Country:US
Mailing Address - Phone:772-233-8374
Mailing Address - Fax:
Practice Address - Street 1:889 E PRIMA VISTA BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-2342
Practice Address - Country:US
Practice Address - Phone:772-233-8374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy