Provider Demographics
NPI:1467726182
Name:SOUTH BROWARD HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SOUTH BROWARD HOSPITAL DISTRICT
Other - Org Name:MHP OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:VISHWAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:954-883-8007
Mailing Address - Street 1:7800 SHERIDAN ST
Mailing Address - Street 2:2ND FLOOR - MAIN PHARMACY
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2536
Mailing Address - Country:US
Mailing Address - Phone:954-883-8008
Mailing Address - Fax:954-883-7040
Practice Address - Street 1:7800 SHERIDAN ST
Practice Address - Street 2:2ND FLOOR - MAIN PHARMACY
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-2536
Practice Address - Country:US
Practice Address - Phone:954-883-8008
Practice Address - Fax:954-883-7040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH134543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy