Provider Demographics
NPI:1932244555
Name:GARON PHARMACY INC.
Entity Type:Organization
Organization Name:GARON PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASPER
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMPOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:REG PH
Authorized Official - Phone:727-577-3170
Mailing Address - Street 1:8000 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3653
Mailing Address - Country:US
Mailing Address - Phone:727-577-3170
Mailing Address - Fax:727-578-2977
Practice Address - Street 1:8000 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3653
Practice Address - Country:US
Practice Address - Phone:727-577-3170
Practice Address - Fax:727-578-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH74203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1039191Medicare UPIN
FL0943690001Medicare NSC