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General NPI Number Information
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NPI Number | 1477914109
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Entity Type | Organization
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Legal Business Name | POPS NEIGHBORHOOD PHARMACY, LLC
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 20 NE 2ND AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-3504
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Country | US
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Telephone | 754-227-7252
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Fax | 754-227-7788
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Provider Business Mailing Address
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Address Line | 20 NE 2ND AVE
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-3504
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Country | US
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Telephone | 754-227-7252
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Fax | 754-227-7788
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. ELAINA LIVA
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Credential |
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Telephone | 754-227-7252
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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 | 25641
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License Number State | FL
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