Healthcare Provider Details

I. General information

NPI: 1487088845
Provider Name (Legal Business Name): PHARMA HOLDINGS US OF FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2013
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 S MILITARY TRL
DEERFIELD BEACH FL
33442-3025
US

IV. Provider business mailing address

5710 LBJ FWY SUITE 325
DALLAS TX
75240-6324
US

V. Phone/Fax

Practice location:
  • Phone: 954-990-2204
  • Fax: 954-990-2205
Mailing address:
  • Phone: 214-888-8099
  • Fax: 214-261-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number29199
License Number StateCA

VIII. Authorized Official

Name: CARY ROSSEL
Title or Position: CEO
Credential:
Phone: 954-990-2204