=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851690440
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPSULE PHARMACY CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2011
-----------------------------------------------------
Last Update Date | 03/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2219 W HILLSBORO BLVD
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-1108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-246-5300
-----------------------------------------------------
Fax | 954-246-5301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2219 W HILLSBORO BLVD
-----------------------------------------------------
City | DEERFIELD BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33442-1108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-246-5300
-----------------------------------------------------
Fax | 954-246-5301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PD
-----------------------------------------------------
Name | ALINE LECA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-246-5300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | PH25348
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------