Provider Demographics
NPI:1609054808
Name:MEDICAL ARTS PHARMACY SERVICES
Entity Type:Organization
Organization Name:MEDICAL ARTS PHARMACY SERVICES
Other - Org Name:MEDICAL ARTS PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANCELOT
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-541-8201
Mailing Address - Street 1:10412 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5605
Mailing Address - Country:US
Mailing Address - Phone:954-541-8201
Mailing Address - Fax:954-827-0616
Practice Address - Street 1:10412 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-5605
Practice Address - Country:US
Practice Address - Phone:954-541-8201
Practice Address - Fax:954-827-0616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH224343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2010743OtherPK