OrganizationAva Kerolos Llc(Good Samaritan Pharmacy)PharmacySuppliersPractice Address33338 U.S. Hwy 19 N., Palm Harbor, FL 34684(727) 785-2640(727) 785-2650PECOS EnrollmentBased on the most recent information from CMS, provider Ava Kerolos Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1659764959Provider TypeOrganizationFull NameAva Kerolos LlcOther NameGood Samaritan PharmacySubpartNoEnumeration Date3/10/2015Last Updated12/28/2021Contact InformationPractice LocationPractice Address33338 U.S. Hwy 19 N., Palm Harbor, FL 34684Phone(727) 785-2640Fax(727) 784-0701Mailing LocationMailing Address33338 U.S. Hwy 19 N., Palm Harbor, FL 34684Phone(727) 785-2650Fax(727) 785-2827Authorized OfficialNameRoufail, Eman (Owner)Phone(615) 554-8105Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicensePH28867FloridaCode333600000XDescriptionPharmacySuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID014789900DescriptionMedicaidIssuerUnlistedFloridaID2150855DescriptionOtherIssuerPK