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General NPI Number Information
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NPI Number | 1902156284
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Entity Type | Organization
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Legal Business Name | FILL-A-SCRIPT PHARMACY
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 2500 SW 107TH AVE STE 30
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City | MIAMI
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State | FL
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Zip | 33165-2492
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Country | US
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Telephone | 305-226-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 SW 107TH AVE #30
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City | MIAMI
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State | FL
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Zip | 33165
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Country | US
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Telephone | 305-226-0181
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DARLIN ROMAN
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Credential |
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Telephone | 786-300-9150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH26327
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26326
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License Number State | FL
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