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General NPI Number Information
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NPI Number | 1851438527
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Entity Type | Organization
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Legal Business Name | DELTONA MEDICAL ARTS PHARMACY INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 921 TOWN CENTER DR STE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8266
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Country | US
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Telephone | 386-774-7933
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Fax | 386-774-7944
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Provider Business Mailing Address
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Address Line | 921 TOWN CENTER DR SUITE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8311
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Country | US
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Telephone | 386-774-7933
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Fax | 386-774-7944
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Authorized Official
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Title or Position | PRESIDENT
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Name | MUKESH AMIN
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Credential | PHARMACIST
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Telephone | 386-774-7933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 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 #3
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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 #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH10785
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License Number State | FL
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