Provider Demographics
NPI:1003083569
Name:WHITE ORCHID PHARMACY INC
Entity Type:Organization
Organization Name:WHITE ORCHID PHARMACY INC
Other - Org Name:WHITE ORCHID PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARKO
Authorized Official - Middle Name:
Authorized Official - Last Name:JARIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-404-7533
Mailing Address - Street 1:2328B HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-1201
Mailing Address - Country:US
Mailing Address - Phone:954-404-7533
Mailing Address - Fax:954-404-7536
Practice Address - Street 1:2328B HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-1201
Practice Address - Country:US
Practice Address - Phone:954-404-7542
Practice Address - Fax:954-404-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH237493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2120052OtherPK