Provider Demographics
NPI:1568461937
Name:PULMONARY PRESCRIPTION PROVIDERS
Entity Type:Organization
Organization Name:PULMONARY PRESCRIPTION PROVIDERS
Other - Org Name:I.V. & PULMONARY PRESCRIPTION PROVIDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HELFAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-966-6730
Mailing Address - Street 1:3129 W HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5121
Mailing Address - Country:US
Mailing Address - Phone:954-966-6730
Mailing Address - Fax:954-966-6771
Practice Address - Street 1:3129 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5121
Practice Address - Country:US
Practice Address - Phone:954-966-6730
Practice Address - Fax:954-966-6771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 10999333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP6439OtherBCBS OF FL
FL101910400Medicaid
FL101910401Medicaid
FLP6439OtherBCBS OF FL