Provider Demographics
NPI:1669856357
Name:EMPATH HEALTH PHARMACEUTICALS LLC
Entity Type:Organization
Organization Name:EMPATH HEALTH PHARMACEUTICALS LLC
Other - Org Name:EMPATH HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUHAMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-552-7500
Mailing Address - Street 1:5771 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4703 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3734
Practice Address - Country:US
Practice Address - Phone:727-586-4432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH292263336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017015500Medicaid