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General NPI Number Information
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NPI Number | 1811430945
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Entity Type | Organization
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Legal Business Name | BOOTS LLC
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 450 NE 125TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4754
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Country | US
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Telephone | 305-677-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 7326 ROYAL PALM BLVD
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City | MARGATE
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State | FL
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Zip | 33063-6804
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Country | US
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Telephone | 954-317-3688
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | STEPHEN BANJOKO
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Credential |
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Telephone | 212-257-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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