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General NPI Number Information
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NPI Number | 1134437403
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Entity Type | Organization
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Legal Business Name | EMERALD HILLS PHARMACY LLC
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 3000 STIRLING RD STE 120
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2069
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Country | US
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Telephone | 954-983-3336
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Fax | 954-985-0114
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Provider Business Mailing Address
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Address Line | 3000 STIRLING RD STE 120
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2069
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RACHEL NOVELLI
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Credential |
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Telephone | 954-983-3336
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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 | PH24873
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License Number State | FL
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