Provider Demographics
NPI:1477914109
Name:POPS NEIGHBORHOOD PHARMACY, LLC
Entity Type:Organization
Organization Name:POPS NEIGHBORHOOD PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-227-7252
Mailing Address - Street 1:20 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-3504
Mailing Address - Country:US
Mailing Address - Phone:754-227-7252
Mailing Address - Fax:754-227-7788
Practice Address - Street 1:20 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-3504
Practice Address - Country:US
Practice Address - Phone:754-227-7252
Practice Address - Fax:754-227-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL256413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy