Provider Demographics
NPI:1225564107
Name:A PLUS PHARMACY & MEDICAL SUPPLY
Entity Type:Organization
Organization Name:A PLUS PHARMACY & MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOURANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:954-687-0774
Mailing Address - Street 1:1303 SE 17TH ST
Mailing Address - Street 2:SUITE D1
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1722
Mailing Address - Country:US
Mailing Address - Phone:954-687-0774
Mailing Address - Fax:954-752-3989
Practice Address - Street 1:1303 SE 17TH ST
Practice Address - Street 2:SUITE D1
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1722
Practice Address - Country:US
Practice Address - Phone:954-687-0774
Practice Address - Fax:954-752-3989
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
FLPH30690332B00000X, 332BP3500X, 333600000X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy