Provider Demographics
NPI:1588647788
Name:L VASSAR INC
Entity Type:Organization
Organization Name:L VASSAR INC
Other - Org Name:SOUTH BROWARD MEDICAL ARTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:VASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:954-923-6322
Mailing Address - Street 1:599 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4107
Mailing Address - Country:US
Mailing Address - Phone:954-923-6322
Mailing Address - Fax:954-923-6727
Practice Address - Street 1:599 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-4107
Practice Address - Country:US
Practice Address - Phone:954-923-6322
Practice Address - Fax:954-923-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH0016826333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy