Healthcare Provider Details

I. General information

NPI: 1336605492
Provider Name (Legal Business Name): PHARMOSTAR INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9540 GRIFFIN RD
COOPER CITY FL
33328-3416
US

IV. Provider business mailing address

9540 GRIFFIN RD
COOPER CITY FL
33328-3416
US

V. Phone/Fax

Practice location:
  • Phone: 954-330-6558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JENELL JONES
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 954-330-6558