Healthcare Provider Details

I. General information

NPI: 1922103183
Provider Name (Legal Business Name): LEWIS PHARMACY OF THE PALM BECAHES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/25/2008
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

235 S COUNTY RD
PALM BEACH FL
33480-4294
US

V. Phone/Fax

Practice location:
  • Phone: 561-655-7867
  • Fax:
Mailing address:
  • Phone: 561-655-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH 22226
License Number StateFL

VIII. Authorized Official

Name: MIPAL PATEL
Title or Position: PRESIDENT
Credential:
Phone: 561-655-7867