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General NPI Number Information
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NPI Number | 1104187822
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Entity Type | Organization
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Legal Business Name | GREEN APPLE PHARMACY INC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 4545 FOREST HILL BLVD BAY 3
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9144
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Country | US
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Telephone | 561-649-4242
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Fax | 561-649-4241
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Provider Business Mailing Address
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Address Line | 4545 FOREST HILL BLVD BAY 3
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9144
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Country | US
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Telephone | 561-649-4242
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Fax | 561-649-4241
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. OLUCHI IKE
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Credential | PHARMACIST
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Telephone | 561-649-4242
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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 |
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License Number State | FL
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