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General NPI Number Information
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NPI Number | 1326557422
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Entity Type | Organization
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Legal Business Name | BAL PHARMACY INC
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 7300 W MCNAB RD STE 112
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City | TAMARAC
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State | FL
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Zip | 33321-5329
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Country | US
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Telephone | 954-366-6137
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Fax | 754-205-6118
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Provider Business Mailing Address
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Address Line | 7300 W MCNAB RD STE 112
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City | TAMARAC
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State | FL
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Zip | 33321-5329
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Country | US
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Telephone | 954-366-6137
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Fax | 754-205-6118
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Authorized Official
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Title or Position | CEO
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Name | BEATRICE LOUISSAINT
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Credential |
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Telephone | 954-643-6443
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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 | PH30746
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License Number State | FL
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