Healthcare Provider Details

I. General information

NPI: 1245399732
Provider Name (Legal Business Name): CENTURY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7531 MAYO ST
CENTURY FL
32535-2906
US

IV. Provider business mailing address

7531 MAYO ST
CENTURY FL
32535-2906
US

V. Phone/Fax

Practice location:
  • Phone: 850-256-3472
  • Fax: 850-256-3529
Mailing address:
  • Phone: 850-256-3472
  • Fax: 850-256-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH18261
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH18261
License Number StateFL

VIII. Authorized Official

Name: MRS. JULIE L BOOTH-MORAN
Title or Position: MANAGING MEMBER
Credential: RPH
Phone: 850-256-3472