Provider Demographics
NPI:1811236938
Name:CITRUS SPRINGS PHARMACY INC
Entity Type:Organization
Organization Name:CITRUS SPRINGS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:OSARHIEME
Authorized Official - Middle Name:
Authorized Official - Last Name:IGBINOBA OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-329-8454
Mailing Address - Street 1:10479 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-3268
Mailing Address - Country:US
Mailing Address - Phone:352-489-1341
Mailing Address - Fax:352-489-1343
Practice Address - Street 1:10479 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-3268
Practice Address - Country:US
Practice Address - Phone:352-489-1341
Practice Address - Fax:352-489-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH267053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy