Healthcare Provider Details

I. General information

NPI: 1114046729
Provider Name (Legal Business Name): LINGS HLTHMT PHCY AND WELLNESS CTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8608 GRIFFIN RD
COOPER CITY FL
33328-3719
US

IV. Provider business mailing address

8608 GRIFFIN RD
COOPER CITY FL
33328-3719
US

V. Phone/Fax

Practice location:
  • Phone: 954-252-9450
  • Fax: 954-252-8450
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22609
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HUSTON POWELL
Title or Position: PRESIDENT
Credential: PHRMD
Phone: 954-252-9450