Basic Information
| Provider Information | |||||||||
| NPI: | 1407595622 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEBRON PHARMACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2812 W DR. MLK JR BLVD | ||||||||
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| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133042221 | ||||||||
| FaxNumber: | 8882398423 | ||||||||
| Practice Location | |||||||||
| Address1: | 96 INTEGRITY DRIVE | ||||||||
| Address2: | SUITE D | ||||||||
| City: | HEBRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7409283455 | ||||||||
| FaxNumber: | 7409283450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2022 | ||||||||
| LastUpdateDate: | 06/04/2022 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | HARDIKKUMAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9733626086 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.