Healthcare Provider Details

I. General information

NPI: 1053039743
Provider Name (Legal Business Name): PRESCRIPTIONS UNLIMITED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 SIMPSON RD STE 102
KISSIMMEE FL
34744-5328
US

IV. Provider business mailing address

831 SIMPSON RD STE 102
KISSIMMEE FL
34744-5328
US

V. Phone/Fax

Practice location:
  • Phone: 407-750-9313
  • Fax: 407-750-9314
Mailing address:
  • Phone: 407-750-9313
  • Fax: 407-750-9314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC J LARSON
Title or Position: AUTHORIZED MEMBER
Credential: PHARMD
Phone: 407-750-9313