Provider Demographics
NPI:1275188898
Name:EAST BOCA PHARMACY, LLC
Entity Type:Organization
Organization Name:EAST BOCA PHARMACY, LLC
Other - Org Name:EAST BOCA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-418-7001
Mailing Address - Street 1:4800 NW 2ND AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-672-1888
Mailing Address - Fax:561-717-4128
Practice Address - Street 1:4800 NW 2ND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-672-1888
Practice Address - Fax:561-717-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy