Provider Demographics
NPI:1578560074
Name:D.B.M. DISTRIBUTORS
Entity Type:Organization
Organization Name:D.B.M. DISTRIBUTORS
Other - Org Name:KEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:PORT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:305-361-5445
Mailing Address - Street 1:614 CRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-2008
Mailing Address - Country:US
Mailing Address - Phone:305-361-5445
Mailing Address - Fax:305-361-1064
Practice Address - Street 1:614 CRANDON BLVD
Practice Address - Street 2:
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149-2008
Practice Address - Country:US
Practice Address - Phone:305-361-5445
Practice Address - Fax:305-361-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0006630333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy