Healthcare Provider Details

I. General information

NPI: 1982978011
Provider Name (Legal Business Name): AMERICAN OUTCOMES MANAGEMENT OF NEW YORK LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 NW 17TH AVE STE 103
DELRAY BEACH FL
33445-2552
US

IV. Provider business mailing address

1395 NW 17TH AVE STE 103
DELRAY BEACH FL
33445-2551
US

V. Phone/Fax

Practice location:
  • Phone: 561-860-8300
  • Fax: 561-860-8319
Mailing address:
  • Phone: 561-860-8300
  • Fax: 561-860-8319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH25975
License Number StateFL

VIII. Authorized Official

Name: SHERRI BENSON
Title or Position: COO
Credential:
Phone: 800-556-4246