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General NPI Number Information
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NPI Number | 1700333606
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Entity Type | Organization
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Legal Business Name | EZ RX BOYNTON BEACH LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 190 GLADES RD STE A
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City | BOCA RATON
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State | FL
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Zip | 33432-1642
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Country | US
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Telephone | 561-336-2617
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Fax | 561-336-2619
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Provider Business Mailing Address
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Address Line | 190 GLADES RD STE A
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City | BOCA RATON
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State | FL
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Zip | 33432-1642
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Country | US
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Telephone | 561-336-2617
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Fax | 561-336-2619
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Authorized Official
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Title or Position | OWNER
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Name | JASON LAVOIE
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Credential |
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Telephone | 954-394-5374
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH30330
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License Number State | FL
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