Provider Demographics
NPI:1376803718
Name:AFFORDABLE COMMUNITY PHARMACY
Entity Type:Organization
Organization Name:AFFORDABLE COMMUNITY PHARMACY
Other - Org Name:MICHAEL'S DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-455-2689
Mailing Address - Street 1:3011 LINTON BLVD
Mailing Address - Street 2:103
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6505
Mailing Address - Country:US
Mailing Address - Phone:561-455-2689
Mailing Address - Fax:
Practice Address - Street 1:4801 LINTON BLVD
Practice Address - Street 2:A4
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6503
Practice Address - Country:US
Practice Address - Phone:561-455-2689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH261303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy