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General NPI Number Information
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NPI Number | 1184437303
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Entity Type | Organization
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Legal Business Name | REPLENISHRX CONCIERGE LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 7967 W MCNAB RD
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City | TAMARAC
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State | FL
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Zip | 33321-8428
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Country | US
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Telephone | 623-341-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 5804 NW 123RD AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-1936
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Country | US
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Telephone | 623-341-1000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHENATE TABORA
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Credential | RN
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Telephone | 623-341-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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