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General NPI Number Information
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NPI Number | 1619492691
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Entity Type | Organization
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Legal Business Name | WEST PALM BEACH PHARMACEUTICALS LLC
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 2601 S MILITARY TRL STE 25
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-7512
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Country | US
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Telephone | 561-660-7869
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Fax | 561-660-7879
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Provider Business Mailing Address
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Address Line | 2601 S MILITARY TRL STE 25
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-7512
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Country | US
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Telephone | 561-660-7869
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Fax | 561-660-7879
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Authorized Official
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Title or Position | MANAGER
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Name | XIMENA SUSANA PACHECO-VELIZ
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Credential |
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Telephone | 561-254-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH30890
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License Number State | FL
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