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General NPI Number Information
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NPI Number | 1275120933
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Entity Type | Organization
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Legal Business Name | PREVENT RX 3, LLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2372 WILTON DR
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City | WILTON MANORS
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State | FL
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Zip | 33305-2267
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Country | US
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Telephone | 754-701-0225
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Fax | 754-600-3729
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Provider Business Mailing Address
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Address Line | 2372 WILTON DR
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City | WILTON MANORS
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State | FL
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Zip | 33305-2267
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Country | US
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Telephone | 754-701-0225
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Fax | 754-600-3729
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Authorized Official
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Title or Position | CONTRACTING & LICENSING SPECIALIST
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Name | TAMMY FREEMAN
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Credential |
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Telephone | 754-701-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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