Provider Demographics
NPI:1871969824
Name:PHARMACY BENEFIT SOLUTIONS LLC
Entity type:Organization
Organization Name:PHARMACY BENEFIT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VINANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-857-7334
Mailing Address - Street 1:2240 BELLEAIR RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-2798
Mailing Address - Country:US
Mailing Address - Phone:727-451-6800
Mailing Address - Fax:727-451-6820
Practice Address - Street 1:2240 BELLEAIR RD
Practice Address - Street 2:SUITE 260
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-2798
Practice Address - Country:US
Practice Address - Phone:727-451-6800
Practice Address - Fax:727-451-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management