Provider Demographics
NPI:1407864630
Name:LANDMARK DRUGS INC
Entity Type:Organization
Organization Name:LANDMARK DRUGS INC
Other - Org Name:PFEIFFER DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-433-5404
Mailing Address - Street 1:PO BOX 17326
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32522-7326
Mailing Address - Country:US
Mailing Address - Phone:850-433-5404
Mailing Address - Fax:850-469-4411
Practice Address - Street 1:2501 W CERVANTES ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-7152
Practice Address - Country:US
Practice Address - Phone:850-433-5404
Practice Address - Fax:850-469-4411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336S0011X
FLPH167593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1006546OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL021728000Medicaid
FL021728001Medicaid
FL021728000Medicaid