Provider Demographics
NPI:1114317898
Name:LIFE WORTH LIVING FOUNDATION INC
Entity Type:Organization
Organization Name:LIFE WORTH LIVING FOUNDATION INC
Other - Org Name:LIFE WORTH LIVING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:EVER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-522-5633
Mailing Address - Street 1:6488 CURRIN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6207
Mailing Address - Country:US
Mailing Address - Phone:407-522-5633
Mailing Address - Fax:407-522-5684
Practice Address - Street 1:6488 CURRIN DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6207
Practice Address - Country:US
Practice Address - Phone:407-522-5633
Practice Address - Fax:407-522-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 274563336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154855OtherPK
6624390001Medicare NSC