Healthcare Provider Details
I. General information
NPI: 1659995975
Provider Name (Legal Business Name): PHARMACY FAMILIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2020
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
450 W HILLSBORO BLVD
DEERFIELD BEACH FL
33441-1604
US
IV. Provider business mailing address
450 W HILLSBORO BLVD
DEERFIELD BEACH FL
33441-1604
US
V. Phone/Fax
- Phone: 954-531-0461
- Fax: 954-531-0713
- Phone: 954-531-0461
- Fax: 954-531-0713
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARTHUR
SODERBERG
Title or Position: CFO
Credential:
Phone: 954-531-0461