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General NPI Number Information
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NPI Number | 1407550528
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Entity Type | Organization
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Legal Business Name | ADW DIABETES LLC
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 701 MARKET ST STE 108B
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32095-8803
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Country | US
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Telephone | 877-241-9002
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Fax | 954-975-3786
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Provider Business Mailing Address
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Address Line | 2501 NW 34TH PL STE 35
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City | POMPANO BEACH
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State | FL
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Zip | 33069-5930
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Country | US
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Telephone | 877-241-9002
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Fax | 954-975-3786
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | ROBERT MICHAEL MCMAHON
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Credential | RPH
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Telephone | 877-241-9002
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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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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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