Provider Demographics
NPI:1639185101
Name:C D M & S, INC
Entity Type:Organization
Organization Name:C D M & S, INC
Other - Org Name:THE DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKOLOVE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-395-1650
Mailing Address - Street 1:225 E PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5013
Mailing Address - Country:US
Mailing Address - Phone:561-395-1650
Mailing Address - Fax:561-395-8529
Practice Address - Street 1:225 E PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5013
Practice Address - Country:US
Practice Address - Phone:561-395-1650
Practice Address - Fax:561-395-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH1909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1016946Medicaid