Provider Demographics
NPI:1477839900
Name:BELAMY, PHIL (RPH)
Entity Type:Individual
Prefix:
First Name:PHIL
Middle Name:
Last Name:BELAMY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12253 TEMPLE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2236
Mailing Address - Country:US
Mailing Address - Phone:561-422-1690
Mailing Address - Fax:
Practice Address - Street 1:12253 TEMPLE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412
Practice Address - Country:US
Practice Address - Phone:561-422-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PS37315OtherPHARMACIST LICENCE