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General NPI Number Information
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NPI Number | 1447440250
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Entity Type | Organization
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Legal Business Name | LIFEMED PHARMACY LLC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 447 DOUGHTY BLVD
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City | INWOOD
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State | NY
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Zip | 11096-1345
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Country | US
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Telephone | 847-350-3446
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Fax | 954-748-1170
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Provider Business Mailing Address
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Address Line | 4577 N NOB HILL RD #209
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City | SUNRISE
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State | FL
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Zip | 33351-4712
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Country | US
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Telephone | 847-350-3446
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Fax | 954-748-1170
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Authorized Official
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Title or Position | CONTROLLER
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Name | JENNIFER THOMAS
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Credential |
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Telephone | 847-350-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 028485
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0000983
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License Number State | CT
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