Provider Demographics
NPI:1346446531
Name:PHARMACY ONE INC
Entity Type:Organization
Organization Name:PHARMACY ONE INC
Other - Org Name:ROBERTS DRUG STORE #3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-637-8311
Mailing Address - Street 1:2505 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-2947
Mailing Address - Country:US
Mailing Address - Phone:305-637-8311
Mailing Address - Fax:305-637-8227
Practice Address - Street 1:2505 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-2947
Practice Address - Country:US
Practice Address - Phone:305-637-8311
Practice Address - Fax:305-637-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH17820332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1092725OtherNABP
FL0226653001Medicaid
FL4054080001Medicare ID - Type UnspecifiedPROVIDER