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General NPI Number Information
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NPI Number | 1508162017
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Entity Type | Organization
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Legal Business Name | VIP PHARMACY OF LAKE WORTH
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 3093 LAKE WORTH RD
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3631
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Country | US
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Telephone | 561-433-9933
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Fax | 561-433-9969
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Provider Business Mailing Address
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Address Line | 3093 LAKE WORTH RD
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3631
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Country | US
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Telephone | 561-433-9933
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Fax | 561-433-9969
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Authorized Official
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Title or Position | OWNER
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Name | NEIL KAUFMAN
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Credential |
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Telephone | 561-951-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH25221
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License Number State | FL
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