Healthcare Provider Details

I. General information

NPI: 1033549134
Provider Name (Legal Business Name): OPHARMA GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 W ATLANTIC AVE SUITE 2
DELRAY BEACH FL
33445-3706
US

IV. Provider business mailing address

4733 W ATLANTIC AVE SUITE 2
DELRAY BEACH FL
33445-3706
US

V. Phone/Fax

Practice location:
  • Phone: 561-270-3238
  • Fax: 561-270-3540
Mailing address:
  • Phone: 561-270-3238
  • Fax: 561-270-3540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH27240
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH27241
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH27240
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPH27241
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPH27240
License Number StateFL

VIII. Authorized Official

Name: MR. BRYAN LARA
Title or Position: COO
Credential:
Phone: 561-270-2898