Provider Demographics
NPI:1477552818
Name:PHARMACY 18, INC.
Entity Type:Organization
Organization Name:PHARMACY 18, INC.
Other - Org Name:LIFE QUALITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-495-9200
Mailing Address - Street 1:5180 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8103
Mailing Address - Country:US
Mailing Address - Phone:561-495-9200
Mailing Address - Fax:561-495-0210
Practice Address - Street 1:82 SPRUCE ST
Practice Address - Street 2:SUITE 118
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2150
Practice Address - Country:US
Practice Address - Phone:561-495-9200
Practice Address - Fax:561-495-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY332B00000X
KYP06805333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP8504OtherBLUE CROSS BLUE SHIELD
FLP8504OtherBLUE CROSS BLUE SHIELD