1720220775 NPI number — FOCUS ON HEALTH RX LLC

Table of content: (NPI 1720220775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720220775 NPI number — FOCUS ON HEALTH RX LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOCUS ON HEALTH RX LLC
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:
Provider Other Organization Name Type Code:
6
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:
1720220775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5301 W BROWARD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANTATION
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33317-2611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-979-9771
Provider Business Mailing Address Fax Number:
954-979-9645

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 WYNMOOR CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COCONUT CREEK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33066-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-797-9771
Provider Business Practice Location Address Fax Number:
954-979-9645
Provider Enumeration Date:
04/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SWEET
Authorized Official First Name:
FRANCINE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
954-615-1200

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PH24461 , 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: PH24461 . This is a "PHARMACY LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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