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General NPI Number Information
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NPI Number | 1225477862
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Entity Type | Organization
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Legal Business Name | MALABAR PHARMACY LLC
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 930 MALABAR RD SE STE 1
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City | PALM BAY
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State | FL
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Zip | 32907-3252
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Country | US
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Telephone | 321-775-0911
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Fax | 877-232-9689
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Provider Business Mailing Address
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Address Line | 930 MALABAR RD SE STE 1
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City | PALM BAY
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State | FL
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Zip | 32907-3252
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Country | US
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Telephone | 321-775-0911
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Fax | 877-232-9689
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Authorized Official
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Title or Position | MANAGER/PHARMACIST
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Name | ANKUR SHAH
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Credential | RPH
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Telephone | 321-775-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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