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General NPI Number Information
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NPI Number | 1083937395
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Entity Type | Organization
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Legal Business Name | GOODLIFE PHARMACY INC
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 8903 GLADES RD STE G13
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City | BOCA RATON
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State | FL
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Zip | 33434-4091
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Country | US
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Telephone | 561-999-8855
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Fax | 888-688-6310
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Provider Business Mailing Address
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Address Line | 8903 GLADES RD STE G13
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City | BOCA RATON
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State | FL
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Zip | 33434-4091
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Country | US
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Telephone | 561-999-8855
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Fax | 888-688-6310
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDUARDO GIL
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Credential |
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Telephone | 561-999-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | NP000002
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24484
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License Number State | FL
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