MEDICARE: CUBANE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy

General Provider Information

NPI Number	:	1033973789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUBANE LLC

Provider Business Mailing Address
First Line	:	8170 OKEECHOBEE BLVD STE 4
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-2159
Country	:	US
Telephone Number	:	888-862-2772
Fax Number	:

Provider Business Practice Location Address
First Line	:	8170 OKEECHOBEE BLVD STE 4
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-2159
Country	:	US
Telephone Number	:	888-862-2772
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	HAYDEN COLLIER
Credential	:	PHARMD
Telephone Number	:	888-862-2772

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	02/12/2024

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Directions to “CUBANE LLC ” Practice Location

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