Provider Demographics
NPI:1558681056
Name:MEDPOINT PHARMACY INCORPORATED
Entity Type:Organization
Organization Name:MEDPOINT PHARMACY INCORPORATED
Other - Org Name:MEDPOINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKRITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-937-9930
Mailing Address - Street 1:23020 SANDALFOOT PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6654
Mailing Address - Country:US
Mailing Address - Phone:561-451-2111
Mailing Address - Fax:
Practice Address - Street 1:23020 SANDALFOOT PLAZA DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6654
Practice Address - Country:US
Practice Address - Phone:561-451-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH246553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2125364OtherPK