Provider Demographics
NPI:1376931634
Name:PHYSICIANS PHARMACY
Entity Type:Organization
Organization Name:PHYSICIANS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-480-7577
Mailing Address - Street 1:6299 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6180
Mailing Address - Country:US
Mailing Address - Phone:888-480-7577
Mailing Address - Fax:954-906-2236
Practice Address - Street 1:6299 W SUNRISE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:888-480-7577
Practice Address - Fax:954-906-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy