1134445000 NPI number — NEW MARGATE PHARMACY INC

Table of content: (NPI 1134445000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134445000 NPI number — NEW MARGATE PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW MARGATE PHARMACY 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:
NEW MARGATE PHARMACY
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:
1134445000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2926 N STATE ROAD 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARGATE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33063-5730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-247-9700
Provider Business Mailing Address Fax Number:
954-366-6171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2926 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARGATE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33063-5730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-247-9700
Provider Business Practice Location Address Fax Number:
954-366-6171
Provider Enumeration Date:
04/16/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEBASTIAN
Authorized Official First Name:
DEEPU
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY MANAGER
Authorized Official Telephone Number:
954-247-9700

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PH24589 , 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: 1056907 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".