Provider Demographics
NPI:1750321501
Name:D&S ENTERPRISES OF VERO BEACH LLC
Entity Type:Organization
Organization Name:D&S ENTERPRISES OF VERO BEACH LLC
Other - Org Name:MILLERS HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:772-778-8585
Mailing Address - Street 1:777 37TH ST
Mailing Address - Street 2:SUITE C100
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4873
Mailing Address - Country:US
Mailing Address - Phone:772-778-8585
Mailing Address - Fax:772-778-8508
Practice Address - Street 1:777 37TH ST
Practice Address - Street 2:SUITE C100
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4873
Practice Address - Country:US
Practice Address - Phone:772-778-8585
Practice Address - Fax:772-778-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH216803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005460OtherPK
FL31188000Medicaid
FL31188000Medicaid