Healthcare Provider Details

I. General information

NPI: 1972784841
Provider Name (Legal Business Name): COMPLETE PHARMACY AND MEDICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5829 NW 158TH ST
MIAMI LAKES FL
33014-6721
US

IV. Provider business mailing address

117 W MULBERRY ST
CHATHAM IL
62629-1328
US

V. Phone/Fax

Practice location:
  • Phone: 305-397-2035
  • Fax: 866-454-5866
Mailing address:
  • Phone: 217-697-5533
  • Fax: 800-830-1813

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 NumberPH28339
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE DRENNAN
Title or Position: PRESIDENT
Credential:
Phone: 217-697-5533