Provider Demographics
NPI:1912218108
Name:PEAK PHARMACY INC
Entity Type:Organization
Organization Name:PEAK PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESCRIPTION DEPARTMENT MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:COSMAS
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:OGUEJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM, PHD
Authorized Official - Phone:813-443-0833
Mailing Address - Street 1:4707 E BUSCH BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-6018
Mailing Address - Country:US
Mailing Address - Phone:813-443-0833
Mailing Address - Fax:813-443-0837
Practice Address - Street 1:4707 E BUSCH BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-6018
Practice Address - Country:US
Practice Address - Phone:813-443-0833
Practice Address - Fax:813-443-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH24705333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy