OrganizationActiveAccepts Medicare
Palmyra Pharmacy LLC
NPI 1497209159 · Community/Retail Pharmacy · Brooksville, FL
Enrolled with Medicare as Part B Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1497209159
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Mohab Haraka, Manager(352) 213-3815
- License
- 30300 (FL)
Specialties & taxonomies
Suppliers
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13080 Cortez Blvd
Brooksville, FL 34613-4854
Phone: (352) 600-7572
Fax: (352) 600-7675
Street-level locationGet directions
Mailing address
13060 Cortez Blvd
Brooksville, FL 34613-4854
Registry dates
- Enumerated
- 2016-08-11
- Last updated
- 2021-12-20
- Certified
- 2021-12-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.