Healthcare Provider Details

I. General information

NPI: 1144628413
Provider Name (Legal Business Name): PHYSICIAN PREFERRED PHARMACY SPECIAL P/E
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2014
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N STATE ROAD 7
MARGATE FL
33063-5726
US

IV. Provider business mailing address

2728 N STATE ROAD 7
MARGATE FL
33063-5726
US

V. Phone/Fax

Practice location:
  • Phone: 954-960-7360
  • Fax:
Mailing address:
  • Phone: 954-233-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH28744
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPH23724
License Number StateFL

VIII. Authorized Official

Name: LORI KAPLAN
Title or Position: PRESIDENT
Credential: RPH
Phone: 954-960-7360