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General NPI Number Information
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NPI Number | 1003123894
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Entity Type | Organization
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Legal Business Name | CND4,INC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 6083 SE FEDERAL HWY STE 107
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City | STUART
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State | FL
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Zip | 34997-8104
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Country | US
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Telephone | 772-678-4000
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Fax | 772-678-4001
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Provider Business Mailing Address
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Address Line | 3599 W WOOLBRIGHT RD
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7243
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Country | US
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Telephone | 561-733-1100
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Fax | 561-733-1104
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | NIRAV PATEL
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Credential |
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Telephone | 561-844-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24844
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License Number State | FL
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