Provider Demographics
NPI:1104187822
Name:GREEN APPLE PHARMACY INC
Entity Type:Organization
Organization Name:GREEN APPLE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUCHI
Authorized Official - Middle Name:
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:561-649-4242
Mailing Address - Street 1:4545 FOREST HILL BLVD
Mailing Address - Street 2:BAY 3
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-9144
Mailing Address - Country:US
Mailing Address - Phone:561-649-4242
Mailing Address - Fax:561-649-4241
Practice Address - Street 1:4545 FOREST HILL BLVD
Practice Address - Street 2:BAY 3
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-9144
Practice Address - Country:US
Practice Address - Phone:561-649-4242
Practice Address - Fax:561-649-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy