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General NPI Number Information
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NPI Number | 1508066739
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Entity Type | Organization
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Legal Business Name | PRESCRIPTION SHOPPES LLC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 864 ORANGE AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4770
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Country | US
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Telephone | 386-253-1691
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Fax | 386-253-1693
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Provider Business Mailing Address
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Address Line | 864 ORANGE AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4770
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Country | US
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Telephone | 386-253-1691
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Fax | 386-253-1693
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. SAMIR V AMIN
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Credential | RPH, CPH, MBA
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Telephone | 407-847-2424
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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 | PH19331
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License Number State | FL
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