NPIMap

Organization Active NPI

University of South Florida Board of Trustees

Doing business as USF Bulls Country Pharmacy

  • Community/Retail Pharmacy
  • Tampa, FL
National Provider Identifier
1568613180
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH23526 Issued in FL
Legal business name
UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES
Doing business as
USF Bulls Country Pharmacy
Practice address
12530 Usf Bull Run Drive
SWC 310
Tampa, FL 33620
Phone
(813) 974-2071
Fax
(813) 974-4383
NPI assigned
Oct 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joseph Puccio, M.D.
Title
Medical Director
Phone
(813) 974-2331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH23526 FL Primary

Addresses

Primary practice location

12530 Usf Bull Run Drive
SWC 310
Tampa, FL 33620

Mailing address

12530 Usf Bull Run Drive
SWC 310
Tampa, FL 33620
Phone (813) 974-2074

Other identifiers 2

IdentifierTypeStateIssuer
115486200MedicaidFL
2117253OtherPK

Other names 1

  • USF Bulls Country Pharmacy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2093598University of South Florida12530 Usf Bull Run Dr, Tampa, FL 33620Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
University of South Florida Board of Trustees11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12530 Usf Bull Run Dr
Tampa, FL 33620
Phone (813) 974-2071

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

4103 Cedar Cir
Tampa, FL 33620
Phone (813) 974-1206

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1568613180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12530 USF BULL RUN DRIVE",
            "address_2": "SWC 310",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33620",
            "telephone_number": "813-974-2074",
            "fax_number": "813-974-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12530 USF BULL RUN DRIVE",
            "address_2": "SWC 310",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33620",
            "telephone_number": "813-974-2071",
            "fax_number": "813-974-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-974-2331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH23526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115486200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USF Bulls Country Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "USF Bulls Country Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.