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General NPI Number Information
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NPI Number | 1912663378
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Entity Type | Organization
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Legal Business Name | WALDRUG, LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 1950 W HILLSBORO BLVD STE 102
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-1445
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Country | US
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Telephone | 561-658-1362
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4189
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-4189
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Country | US
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Telephone | 561-658-1362
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANA OCHOA
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Credential |
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Telephone | 561-444-8399
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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 |
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