Healthcare Provider Details
I. General information
NPI: 1316318637
Provider Name (Legal Business Name): A1ABILITY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/13/2015
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
999 STINSON WAY STE 301
WEST PALM BEACH FL
33411-3741
US
IV. Provider business mailing address
999 STINSON WAY SUITE 301
WEST PALM BEACH FL
33411-3741
US
V. Phone/Fax
- Phone: 561-753-6040
- Fax: 561-753-6042
- Phone: 561-753-6040
- Fax: 561-753-6042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH29450 |
| License Number State | FL |
VIII. Authorized Official
Name:
SAMIR
KOLTA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 561-753-6040