=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326577933
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WINSHIPS PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5643 SE CROOKED OAK AVE UNIT 1C
-----------------------------------------------------
City | HOBE SOUND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33455-8319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-324-8381
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5643 SE CROOKED OAK AVE. UNIT 1C SEABRANCH SQUARE
-----------------------------------------------------
City | HOBE SOUND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-324-8381
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST/SECRETARY
-----------------------------------------------------
Name | DANIEL VACCA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 772-324-8381
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PH30784
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------