Healthcare Provider Details

I. General information

NPI: 1164587598
Provider Name (Legal Business Name): DARJEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 PGA BLVD
PALM BEACH GARDENS FL
33410-2823
US

IV. Provider business mailing address

3401 PGA BLVD
PALM BEACH GARDENS FL
33410-2823
US

V. Phone/Fax

Practice location:
  • Phone: 561-493-8840
  • Fax: 561-493-8847
Mailing address:
  • Phone:
  • Fax:

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 NumberPH18681
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE NOTARTOMASO
Title or Position: OWNER PRES
Credential:
Phone: 561-493-8840