Provider Demographics
NPI:1720069313
Name:ARMENIA PHARMACY, INC.
Entity Type:Organization
Organization Name:ARMENIA PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-932-7574
Mailing Address - Street 1:8338 N ARMENIA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-2777
Mailing Address - Country:US
Mailing Address - Phone:813-832-7574
Mailing Address - Fax:813-931-3867
Practice Address - Street 1:8338 N ARMENIA AVE
Practice Address - Street 2:STE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-2777
Practice Address - Country:US
Practice Address - Phone:813-832-7574
Practice Address - Fax:813-931-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21152333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5407330001Medicare NSC