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General NPI Number Information
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NPI Number | 1962193607
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Entity Type | Organization
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Legal Business Name | SKNV PHARMACY, LLC
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 3155 SW 10TH ST STE 6A
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-5900
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Country | US
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Telephone | 888-210-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 3155 SW 10TH ST STE 6A
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-5900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN FENSTER
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Credential |
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Telephone | 888-210-8111
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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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