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General NPI Number Information
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NPI Number | 1811933450
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Entity Type | Organization
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Legal Business Name | PHARMACY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 201 NW 70TH AVE SUITE D-E
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City | PLANTATION
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State | FL
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Zip | 33317-2369
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Country | US
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Telephone | 954-641-1448
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Fax | 954-641-1505
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Provider Business Mailing Address
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Address Line | 201 NW 70TH AVE SUITE D-E
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City | PLANTATION
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State | FL
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Zip | 33317-2369
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Country | US
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Telephone | 954-641-1448
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Fax | 954-641-1505
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | JORGE BASTO
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Credential | PHARMD
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Telephone | 954-581-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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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 | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH21749
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License Number State | FL
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