Healthcare Provider Details

I. General information

NPI: 1093829335
Provider Name (Legal Business Name): LANDMARK DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W CERVANTES ST
PENSACOLA FL
32505-7152
US

IV. Provider business mailing address

2501 W CERVANTES ST
PENSACOLA FL
32505-7152
US

V. Phone/Fax

Practice location:
  • Phone: 850-433-5404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH16759
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPH16759
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH16759
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH16759
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPH16759
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPH16759
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberPH16759
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPH16759
License Number StateFL

VIII. Authorized Official

Name: S FAIRMAN
Title or Position: OWNER
Credential:
Phone: 850-433-5404