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General NPI Number Information
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NPI Number | 1043365083
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Entity Type | Organization
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Legal Business Name | HERBMOR COMPOUNDING PHARMACY
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 9111 PEMBROKE RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1638
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Country | US
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Telephone | 954-447-1823
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Fax | 954-447-1826
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Provider Business Mailing Address
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Address Line | 9111 PEMBROKE RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1638
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Country | US
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Telephone | 954-447-1823
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Fax | 954-447-1826
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. OYEBODE OLADIPO OYETUNJI
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Credential | RPH
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Telephone | 954-447-1823
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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 | PH0016857
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License Number State | FL
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