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General NPI Number Information
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NPI Number | 1326094301
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Entity Type | Organization
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Legal Business Name | PERKINS COMPOUNDING PHARMACY INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 4015 20TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-2403
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Country | US
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Telephone | 772-978-6470
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Fax | 772-978-6471
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Provider Business Mailing Address
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Address Line | 4015 20TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-2403
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Country | US
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Telephone | 772-978-6470
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Fax | 772-978-6471
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Authorized Official
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Title or Position | OWNER PHCST
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Name | EDWIN PERKINS
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Credential |
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Telephone | 772-978-6470
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH17348
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License Number State | FL
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