Provider Demographics
NPI:1922644491
Name:MY PRESCRIPTION COACH COM LLC
Entity Type:Organization
Organization Name:MY PRESCRIPTION COACH COM LLC
Other - Org Name:MY PRESCRIPTION COACH COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:813-867-8213
Mailing Address - Street 1:2111 E 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-8636
Mailing Address - Country:US
Mailing Address - Phone:813-867-8213
Mailing Address - Fax:813-443-1398
Practice Address - Street 1:2111 E 93RD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-8636
Practice Address - Country:US
Practice Address - Phone:813-867-8213
Practice Address - Fax:813-443-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy