Provider Demographics
NPI:1093102071
Name:PHC PHARMACY LLC
Entity Type:Organization
Organization Name:PHC PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHABORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-921-6176
Mailing Address - Street 1:1177 GEORGE BUSH BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-7288
Mailing Address - Country:US
Mailing Address - Phone:561-921-6176
Mailing Address - Fax:
Practice Address - Street 1:1177 GEORGE BUSH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-7288
Practice Address - Country:US
Practice Address - Phone:561-921-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH287393336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy