Healthcare Provider Details

I. General information

NPI: 1609054808
Provider Name (Legal Business Name): MEDICAL ARTS PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10412 W ATLANTIC BLVD
CORAL SPRINGS FL
33071-5605
US

IV. Provider business mailing address

10412 W ATLANTIC BLVD
CORAL SPRINGS FL
33071-5605
US

V. Phone/Fax

Practice location:
  • Phone: 954-541-8201
  • Fax: 954-827-0616
Mailing address:
  • Phone: 954-541-8201
  • Fax: 954-827-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22434
License Number StateFL

VIII. Authorized Official

Name: LANCELOT JAMES
Title or Position: CEO
Credential:
Phone: 954-541-8201