Provider Demographics
NPI:1982678918
Name:UGALAND INC
Entity Type:Organization
Organization Name:UGALAND INC
Other - Org Name:CITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MGR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOYE
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM
Authorized Official - Phone:813-248-5405
Mailing Address - Street 1:PO BOX 310256
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33680-0256
Mailing Address - Country:US
Mailing Address - Phone:813-248-5405
Mailing Address - Fax:813-248-5408
Practice Address - Street 1:3302 E MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610
Practice Address - Country:US
Practice Address - Phone:813-248-5405
Practice Address - Fax:813-248-5408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH197503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2006609OtherPK
FL026597700Medicaid