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General NPI Number Information
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NPI Number | 1366774739
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Entity Type | Organization
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Legal Business Name | VILLAGE PHARMACY, LLC
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 1804 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1402
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Country | US
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Telephone | 954-428-3784
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Fax | 954-428-3783
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Provider Business Mailing Address
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Address Line | 1804 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1402
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Country | US
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Telephone | 954-428-3784
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Fax | 954-428-3783
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOSE ANIBAL CABRAL
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Credential |
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Telephone | 954-428-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | PH24818
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License Number State | FL
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