=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396995650
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | S & K PHARMACIES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2008
-----------------------------------------------------
Last Update Date | 01/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7546 WEST COMMERIAL BLVD
-----------------------------------------------------
City | LAUDERHILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-533-5675
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7546 WEST COMMERIAL BLVD
-----------------------------------------------------
City | LAUDERHILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-533-5675
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SERGIO LOPEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-655-1943
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PH23595
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------