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General NPI Number Information
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NPI Number | 1780712323
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Entity Type | Organization
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Legal Business Name | GOODMAN DRUGS OF FL CORP
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 1234 NE 4TH AVENUE SUITE C
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304
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Country | US
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Telephone | 954-764-6257
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Fax | 954-764-3175
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Provider Business Mailing Address
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Address Line | 1078 S POWERLINE ROAD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442
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Country | US
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Telephone | 954-637-8855
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Fax | 855-315-7478
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Authorized Official
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Title or Position | OWNER
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Name | SHERINE BAHNA
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Credential | PHARM. D.
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Telephone | 954-637-8855
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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 | PH 12431
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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