Healthcare Provider Details
I. General information
NPI: 1336260710
Provider Name (Legal Business Name): INTER ISLAND PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
MEDICAL ARTS COMPLEX
ST THOMAS VI
00801
US
IV. Provider business mailing address
PO BOX 11536
ST THOMAS VI
00801-4536
US
V. Phone/Fax
- Phone: 340-774-8988
- Fax: 340-774-8986
- Phone:
- Fax:
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 | 120284152007 |
| License Number State | VI |
VIII. Authorized Official
Name:
ANNA
BENJAMIN
Title or Position: OFFICE MGR
Credential:
Phone: 340-775-0484