Provider Demographics
NPI:1740606128
Name:ARCO PHARMACY LLC
Entity Type:Organization
Organization Name:ARCO PHARMACY LLC
Other - Org Name:ARCO PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUTOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-542-5000
Mailing Address - Street 1:1475 W OKEECHOBEE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2860
Mailing Address - Country:US
Mailing Address - Phone:786-542-5000
Mailing Address - Fax:786-542-5382
Practice Address - Street 1:1475 W OKEECHOBEE RD STE 5
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2860
Practice Address - Country:US
Practice Address - Phone:786-542-5000
Practice Address - Fax:786-542-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH280803336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145480OtherPK