OrganizationSt George Pharmacy Inc(St George Pharmacy)PharmacySuppliersPractice Address31201 Us Highway 19 N, Palm Harbor, FL 34684-4480(727) 772-6868PECOS EnrollmentBased on the most recent information from CMS, provider St George Pharmacy Inc 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 2 days ago.Profile DetailsProvider ID1881757417Provider TypeOrganizationFull NameSt George Pharmacy IncOther NameSt George PharmacySubpartNoEnumeration Date12/18/2006Last Updated7/2/2013Contact InformationPractice LocationPractice Address31201 Us Highway 19 N, Palm Harbor, FL 34684-4480Phone(727) 772-6868Fax(727) 772-6969Mailing LocationMailing Address31201 Us Highway 19 N, Palm Harbor, FL 34684-4480Phone(727) 772-6868Fax(727) 772-6969Authorized OfficialNameAbdelmasih, Shady (Pharmacy Mgr)Phone(727) 772-6868Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicensePH18889FloridaCode332B00000XDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerCode3336C0004XDescriptionPharmacySuppliersLicenseUnlisted IssuerCode3336L0003XDescriptionPharmacySuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID025840700DescriptionMedicaidIssuerUnlistedFloridaID2015172DescriptionOtherIssuerPK