Provider Demographics
NPI:1790208510
Name:GPS PHARMACY-TAMPA LLC
Entity Type:Organization
Organization Name:GPS PHARMACY-TAMPA LLC
Other - Org Name:GULF PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIRIT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-927-2521
Mailing Address - Street 1:2846 BROADWAY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510
Mailing Address - Country:US
Mailing Address - Phone:866-522-2822
Mailing Address - Fax:813-515-5686
Practice Address - Street 1:2846 BROADWAY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510
Practice Address - Country:US
Practice Address - Phone:866-522-2822
Practice Address - Fax:813-515-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH307063336L0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy