Ava Kerolos LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH28867 Issued in FL

Legal business name

AVA KEROLOS LLC

Doing business as

Good Samaritan Pharmacy

Practice address

33338 U.S. Hwy 19 N.
Palm Harbor, FL 34684

Phone

(727) 785-2640

Fax

(727) 784-0701

NPI assigned

Mar 10, 2015

Last updated

Dec 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eman Roufail

Title

Owner

Phone

(615) 554-8105

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• GOOD SAMARITAN PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1659764959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33338 U.S. HWY 19 N.",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-785-2650",
            "fax_number": "727-785-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33338 U.S. HWY 19 N.",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-785-2640",
            "fax_number": "727-784-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVA KEROLOS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "ROUFAIL",
        "authorized_official_first_name": "EMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-554-8105"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH28867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014789900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150855",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOOD SAMARITAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GOOD SAMARITAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Atlas Chiropractic Inc
• Atlas Health Centers (EPIC Clinics - Palm Harbor)
• Melissa Karen Aull, PMHNP
• Brian Keith Aurich, MSPT
• Authentek Iom, LLC
• Nicholas Abraam Awad, PHARMD
• Robert Awrey
• B. Ronald Lopez, M.D.P.a.
• Lalana Babugowda, MD
• Tobias Bacaner, MD

• Community/Retail Pharmacy in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.