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General NPI Number Information
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NPI Number | 1457496812
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Entity Type | Organization
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Legal Business Name | FRONTIER PHARMACIES
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 12399 SW 53RD ST 105
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City | COOPER CITY
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State | FL
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Zip | 33330-3308
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Country | US
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Telephone | 877-434-3329
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Fax | 954-337-0365
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Provider Business Mailing Address
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Address Line | 12399 SW 53RD ST 105
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City | COOPER CITY
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State | FL
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Zip | 33330-3308
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Country | US
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Telephone | 877-434-3329
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Fax | 954-337-0365
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN GALLINAL
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Credential |
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Telephone | 954-790-9555
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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 | PH19752
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License Number State | FL
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