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General NPI Number Information
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NPI Number | 1023016318
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Entity Type | Organization
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Legal Business Name | DMD PHARMACY SERVICES,LLC
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3501 WEST DR
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-2085
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Country | US
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Telephone | 954-426-9899
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Fax | 954-418-9989
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Provider Business Mailing Address
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Address Line | 10401 NW 53RD ST
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City | SUNRISE
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State | FL
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Zip | 33351-8014
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Country | US
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Telephone | 954-944-4104
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Fax | 954-572-1622
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Authorized Official
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Title or Position | CONTRACT ADMINISTARTOR
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Name | MS. DONNA J MANOS
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Credential |
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Telephone | 954-944-4104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH19200
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License Number State | FL
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