Agevital Pharmacy, LLC
Pharmacy, Compounding Pharmacy in Sarasota, FL. Organization (NPI-2).
NPI number1730428897
StatusActive
Last updated in NPPESFeb 10, 2013
Details
- NPI
- 1730428897
- Entity type
- Organization (NPI-2)
- Legal business name
- Agevital Pharmacy, LLC
- Organization subpart
- No
- Enumeration date
- Feb 10, 2013
- Last updated
- Feb 10, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0004X | Pharmacy, Compounding Pharmacy | – | – | Yes |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Practice location
16 S Blvd Of The PresidentsSarasota, FL 34236-1424
Phone 941-928-8066
Mailing address
16 S Blvd Of The PresidentsSarasota, FL 34236-1424
Phone 941-928-8066
Authorized official
Jenny P. Wilkins
Proprietor/General Manager
9419288066
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