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General NPI Number Information
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NPI Number | 1316294093
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Entity Type | Organization
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Legal Business Name | SOUTH OCEAN PHARMACY INC
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 2875 S OCEAN BLVD SUITE 103
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City | PALM BEACH
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State | FL
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Zip | 33480-5590
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Country | US
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Telephone | 561-721-4359
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Fax | 561-721-4369
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Provider Business Mailing Address
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Address Line | 2875 S OCEAN BLVD SUITE 103
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City | PALM BEACH
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State | FL
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Zip | 33480-5590
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Country | US
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Telephone | 561-721-4359
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Fax | 561-721-4369
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MIPAL PATEL
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Credential |
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Telephone | 973-449-2887
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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 | PH26275
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License Number State | FL
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