Healthcare Provider Details
I. General information
NPI: 1609845502
Provider Name (Legal Business Name): LINTON SQUARE PHARMACY & MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2006
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 S CONGRESS AVE
DELRAY BEACH FL
33445-6368
US
IV. Provider business mailing address
1601 S CONGRESS AVE
DELRAY BEACH FL
33445-6368
US
V. Phone/Fax
- Phone: 561-272-0015
- Fax: 561-272-3059
- Phone: 561-272-0015
- Fax: 561-272-3059
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH24229 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
BEN-AMOZ
Title or Position: BENEFICIAL OWNER
Credential:
Phone: 561-272-0015