Provider Demographics
NPI:1881214096
Name:GOYA MEHDI ENTERPRISE LLC
Entity Type:Organization
Organization Name:GOYA MEHDI ENTERPRISE LLC
Other - Org Name:GOYA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SYED MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-755-4331
Mailing Address - Street 1:5802 N ARMENIA AVE # 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1000
Mailing Address - Country:US
Mailing Address - Phone:813-312-8522
Mailing Address - Fax:
Practice Address - Street 1:5802 N ARMENIA AVE STE 1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1000
Practice Address - Country:US
Practice Address - Phone:813-312-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy