Provider Demographics
NPI:1801068689
Name:FLORIDA DISCOUNTS RX 1 INC
Entity type:Organization
Organization Name:FLORIDA DISCOUNTS RX 1 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:AKIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKARE
Authorized Official - Suffix:
Authorized Official - Credentials:BSC PHARMACY
Authorized Official - Phone:813-382-1513
Mailing Address - Street 1:1911 W MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-425-2195
Mailing Address - Fax:813-343-8922
Practice Address - Street 1:1911 W MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-425-2195
Practice Address - Fax:813-343-8922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
FLPH232333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033694OtherNCPDP PROVIDER IDENTIFICATION NUMBER