Provider Demographics
NPI:1982028890
Name:SPAR USA LLC
Entity Type:Organization
Organization Name:SPAR USA LLC
Other - Org Name:SIGNATURE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SATVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-622-2510
Mailing Address - Street 1:545 N VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3169
Mailing Address - Country:US
Mailing Address - Phone:407-622-2510
Mailing Address - Fax:407-622-2511
Practice Address - Street 1:660 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4779
Practice Address - Country:US
Practice Address - Phone:407-622-2510
Practice Address - Fax:407-622-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH274813336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy