Healthcare Provider Details

I. General information

NPI: 1518331917
Provider Name (Legal Business Name): HSUS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 N FEDERAL HWY STE 2
BOCA RATON FL
33487-4008
US

IV. Provider business mailing address

5800 N FEDERAL HWY SUITE 2
BOCA RATON FL
33487-4024
US

V. Phone/Fax

Practice location:
  • Phone: 888-970-4787
  • Fax: 954-337-3225
Mailing address:
  • Phone: 888-970-4787
  • Fax: 954-337-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 29542
License Number StateFL

VIII. Authorized Official

Name: ANDY DELILLO
Title or Position: CEO
Credential:
Phone: 888-970-4787