Provider Demographics
NPI:1083989115
Name:BELLE GLADE DRUGS LLC
Entity Type:Organization
Organization Name:BELLE GLADE DRUGS LLC
Other - Org Name:K&M DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAITHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-996-0228
Mailing Address - Street 1:364 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3428
Mailing Address - Country:US
Mailing Address - Phone:561-996-0228
Mailing Address - Fax:
Practice Address - Street 1:364 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3428
Practice Address - Country:US
Practice Address - Phone:561-996-0228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH25925333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies