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General NPI Number Information
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NPI Number | 1457129496
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Entity Type | Organization
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Legal Business Name | PHARMACON, INC.
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 160 SW 12TH AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-3119
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Country | US
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Telephone | 888-327-2233
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Fax | 888-439-4453
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Provider Business Mailing Address
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Address Line | 3769 STEWART AVE
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City | MIAMI
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State | FL
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Zip | 33133-6732
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Country | US
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Telephone | 305-582-7303
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Fax |
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Authorized Official
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Title or Position | COO
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Name | RICHARD D MOSS
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Credential | PHARMD
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Telephone | 954-725-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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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 | 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 #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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