Provider Demographics
NPI:1497878326
Name:PHARMACY PRACTICE ASSOCIATES, PA
Entity Type:Organization
Organization Name:PHARMACY PRACTICE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DION
Authorized Official - Middle Name:HAYDEN
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:954-610-0727
Mailing Address - Street 1:4095 STATE ROAD 7
Mailing Address - Street 2:SUITE L-208
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8178
Mailing Address - Country:US
Mailing Address - Phone:954-610-0727
Mailing Address - Fax:
Practice Address - Street 1:4095 STATE ROAD 7
Practice Address - Street 2:SUITE L-208
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-8178
Practice Address - Country:US
Practice Address - Phone:954-610-0727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU60741835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty