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General NPI Number Information
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NPI Number | 1871830034
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Entity Type | Organization
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Legal Business Name | MD OMEGA PHARMACY INC
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 823 SOUTHERN BLVD
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-2529
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Country | US
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Telephone | 561-547-7710
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Fax | 561-547-7719
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Provider Business Mailing Address
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Address Line | 823 SOUTHERN BLVD
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City | WEST PALM BEACH
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State | FL
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Zip | 33405-2529
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Country | US
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Telephone | 561-547-7710
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Fax | 561-547-7719
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Authorized Official
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Title or Position | CO-OWNER SECRETARY
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Name | MRS. ROSA CASTRO
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Credential |
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Telephone | 561-547-7710
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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 |
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License Number State | FL
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