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General NPI Number Information
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NPI Number | 1154507564
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Entity Type | Organization
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Legal Business Name | CHEM RX OF BOCA RATON LLC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 5001 NW 13TH AVE STE H AND I
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City | POMPANO BEACH
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State | FL
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Zip | 33064-8649
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Country | US
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Telephone | 954-426-9322
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Fax | 954-426-9377
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Provider Business Mailing Address
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Address Line | 5001 NW 13TH AVE STE H AND I
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City | POMPANO BEACH
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State | FL
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Zip | 33064-8649
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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 | GENERAL MANG
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Name | IRA PROTAS
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Credential |
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Telephone | 954-426-9322
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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 |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH23134
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License Number State | FL
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