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General NPI Number Information
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NPI Number | 1447555453
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Entity Type | Organization
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Legal Business Name | DIRECT PHARMACY SOURCE, INC
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Dates
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Enumeration Date | 01/22/2011
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3540 NW 56TH ST STE 204
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2260
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Country | US
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Telephone | 877-367-3479
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Fax | 833-347-9329
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Provider Business Mailing Address
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Address Line | 3540 NW 56TH ST STE 204
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2260
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Country | US
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Telephone | 877-367-3479
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Fax | 833-347-9329
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Authorized Official
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Title or Position | CEO
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Name | SATISH SRINIVASAN
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Credential |
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Telephone | 877-997-4276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | FL
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