Healthcare Provider Details

I. General information

NPI: 1932356326
Provider Name (Legal Business Name): PHARMACY DOCTORS ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 10/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-5524
US

IV. Provider business mailing address

205 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-5524
US

V. Phone/Fax

Practice location:
  • Phone: 954-367-5365
  • Fax: 954-367-5366
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH23558
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VERONICA TARAN
Title or Position: PIC
Credential:
Phone: 954-367-5365