Provider Demographics
NPI:1467470336
Name:AKDM RX LLC
Entity Type:Organization
Organization Name:AKDM RX LLC
Other - Org Name:PRESCRIPTION DRUG FOUNDATION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:305-947-0433
Mailing Address - Street 1:1777 NE 163RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4732
Mailing Address - Country:US
Mailing Address - Phone:305-947-0433
Mailing Address - Fax:855-647-1321
Practice Address - Street 1:1777 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4732
Practice Address - Country:US
Practice Address - Phone:305-947-0433
Practice Address - Fax:855-647-1321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BC3200X
FLPH9983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023447500Medicaid
FL1312090001Medicare ID - Type Unspecified