Provider Demographics
NPI:1124554100
Name:G&S PHARMACY LLC.
Entity Type:Organization
Organization Name:G&S PHARMACY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-308-6738
Mailing Address - Street 1:3232 W BROWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1113
Mailing Address - Country:US
Mailing Address - Phone:561-308-6738
Mailing Address - Fax:
Practice Address - Street 1:3232 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1113
Practice Address - Country:US
Practice Address - Phone:561-308-6738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH305043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy