| NPI | 1073931887 |
|---|---|
| Doing Business As | THEO PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RAKESH TAMMABATTULA Owner 347-515-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY53900) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: FL PH30490) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA NP000794) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: OH NRP.022668450-03) | |
| 333600000X Pharmacy (Licence: MN 265225) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NV PH03678) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2017-03-01 |