Healthcare Provider Details

I. General information

NPI: 1316257264
Provider Name (Legal Business Name): EXPRESSCARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 GRIFFIN RD
FORT LAUDERDALE FL
33312-5519
US

IV. Provider business mailing address

3340 GRIFFIN RD
FORT LAUDERDALE FL
33312-5519
US

V. Phone/Fax

Practice location:
  • Phone: 954-399-8003
  • Fax: 954-399-8009
Mailing address:
  • Phone: 954-399-8003
  • Fax: 954-399-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LEONEL PALATNIK
Title or Position: OWNER
Credential:
Phone: 786-252-5628