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General NPI Number Information
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NPI Number | 1356534838
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Entity Type | Organization
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Legal Business Name | PHARMACY VENTURES LLC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 1850 ELDRON BLVD SE UNIT 7
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City | PALM BAY
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State | FL
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Zip | 32909-6870
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Country | US
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Telephone | 321-308-0303
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Fax | 321-308-0310
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Provider Business Mailing Address
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Address Line | PO BOX 223
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City | SEA GIRT
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State | NJ
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Zip | 08750-0223
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Country | US
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Telephone | 866-777-7000
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Fax | 732-280-1350
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Authorized Official
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Title or Position | OWNER, AO
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Name | CHERYL MCDANIEL
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Credential |
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Telephone | 866-777-7000
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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 | PH26928
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License Number State | FL
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