1972893956 NPI number — NATIONWIDE PHARMASSIST OF FLORIDA INC

Table of content: (NPI 1972893956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972893956 NPI number — NATIONWIDE PHARMASSIST OF FLORIDA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONWIDE PHARMASSIST OF FLORIDA INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATIONWIDE PHARMASSIST
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972893956
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1011 SW 30TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEERFIELD BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33442-8104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-397-8160
Provider Business Mailing Address Fax Number:
305-763-8220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 SW 30TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEERFIELD BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33442-8104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-397-8160
Provider Business Practice Location Address Fax Number:
305-763-8220
Provider Enumeration Date:
04/12/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MOLINARI
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
305-397-8160

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PH25374 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2129991 . This is a "PK" identifier . This identifiers is of the category "OTHER".