Healthcare Provider Details

I. General information

NPI: 1437363389
Provider Name (Legal Business Name): LEWIS PHARMACY OF PALM BEACH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 S COUNTY RD
PALM BEACH FL
33480-4294
US

IV. Provider business mailing address

PO BOX 9830
SALT LAKE CITY UT
84109-9830
US

V. Phone/Fax

Practice location:
  • Phone: 561-655-7867
  • Fax: 561-832-1240
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

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 NumberPH22226
License Number StateFL

VIII. Authorized Official

Name: MIPAL PATEL
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 561-655-7867