Healthcare Provider Details

I. General information

NPI: 1063650208
Provider Name (Legal Business Name): PROGRESSIVE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7177 LAKE WORTH RD
LAKE WORTH FL
33467-2906
US

IV. Provider business mailing address

7177 LAKE WORTH RD
LAKE WORTH FL
33467-2906
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-2700
  • Fax: 561-964-2711
Mailing address:
  • Phone: 561-964-2700
  • Fax: 561-964-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHNR001218
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH23575
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number31467
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberNRP.022827700-02
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2017028386
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number035543
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054020452
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberNP000988
License Number StatePA

VIII. Authorized Official

Name: MOHSIN NAEEM
Title or Position: PRESIDENT-PHARMACY MANAGER
Credential: RPH
Phone: 561-964-2700