Healthcare Provider Details
I. General information
NPI: 1154241420
Provider Name (Legal Business Name): BLUE MERCURY MED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3009 GROVE RD
BOYNTON BEACH FL
33435-1661
US
IV. Provider business mailing address
3009 GROVE RD
BOYNTON BEACH FL
33435-1661
US
V. Phone/Fax
- Phone: 864-340-3616
- Fax:
- Phone: 864-340-3616
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARILYN
S
SADLER
Title or Position: MANAGER
Credential:
Phone: 864-340-3616