Provider Demographics
NPI:1811204993
Name:Z-STAT MEDICAL LLC
Entity Type:Organization
Organization Name:Z-STAT MEDICAL LLC
Other - Org Name:OLDSMAR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-547-2780
Mailing Address - Street 1:34911 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 525A
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1966
Mailing Address - Country:US
Mailing Address - Phone:727-781-8124
Mailing Address - Fax:727-781-8190
Practice Address - Street 1:34911 US HIGHWAY 19 N STE 525A
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1966
Practice Address - Country:US
Practice Address - Phone:727-781-8124
Practice Address - Fax:727-781-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH248523336C0003X
3336C0004X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2126643OtherPK