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General NPI Number Information
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NPI Number | 1750665105
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Entity Type | Organization
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Legal Business Name | BOCA DRUGS INC
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 156 NW 20TH ST
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City | BOCA RATON
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State | FL
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Zip | 33431-7949
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Country | US
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Telephone | 561-395-8663
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Fax | 561-395-8664
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Provider Business Mailing Address
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Address Line | 156 NW 20TH ST
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City | BOCA RATON
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State | FL
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Zip | 33431-7949
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Country | US
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Telephone | 561-395-8663
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Fax | 561-395-8664
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Authorized Official
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Title or Position | PHARMACY MGR/ OWNER
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Name | MARY LOUISE DESIMONE
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Credential |
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Telephone | 954-298-1961
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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 | PH25200
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License Number State | FL
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