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General NPI Number Information
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NPI Number | 1356508980
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Entity Type | Organization
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Legal Business Name | PHYTOGENICS LLC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 4501 NW 31ST AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33309-3403
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Country | US
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Telephone | 954-612-5831
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Fax | 800-532-0764
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Provider Business Mailing Address
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Address Line | 4501 NW 31ST AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33309-3403
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Country | US
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Telephone | 954-612-5831
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Fax | 800-532-0764
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Authorized Official
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Title or Position | CEO/PIC
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Name | JOELLE M MOLIERE
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Credential | RPH MPH
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Telephone | 954-612-5831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335G00000X
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Taxonomy Name | Medical Foods Supplier
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH23251
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License Number State | FL
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