Provider Demographics
NPI:1275645103
Name:DMD PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:DMD PHARMACY SERVICES LLC
Other - Org Name:THE VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-944-4104
Mailing Address - Street 1:110 CENTURY BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-2262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13460 SW 10TH ST
Practice Address - Street 2:STE 101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1833
Practice Address - Country:US
Practice Address - Phone:954-450-0212
Practice Address - Fax:954-450-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 3336C0004X, 3336L0003X
FLPH20124333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1006700OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1006700OtherOTHER ID NUMBER
1006700OtherOTHER ID NUMBER-COMMERCIAL NUMBER