Provider Demographics
NPI:1013577253
Name:DELRAY PHARMACY
Entity Type:Organization
Organization Name:DELRAY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:NENEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:561-455-2309
Mailing Address - Street 1:5130 LINTON BLVD STE F6
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6597
Mailing Address - Country:US
Mailing Address - Phone:561-455-2309
Mailing Address - Fax:
Practice Address - Street 1:5130 LINTON BLVD STE F6
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6597
Practice Address - Country:US
Practice Address - Phone:561-455-2309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy