Provider Demographics
NPI:1811221385
Name:GUDOC PHARMACY PLLC
Entity Type:Organization
Organization Name:GUDOC PHARMACY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:UGOCHUKWU
Authorized Official - Middle Name:JO
Authorized Official - Last Name:CHIADI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-381-3971
Mailing Address - Street 1:106 S PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5225
Mailing Address - Country:US
Mailing Address - Phone:813-381-3971
Mailing Address - Fax:813-381-3973
Practice Address - Street 1:106 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5225
Practice Address - Country:US
Practice Address - Phone:813-381-3971
Practice Address - Fax:813-381-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH242643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy