Provider Demographics
NPI:1760591960
Name:BOCA PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:BOCA PHARMACY SERVICES INC
Other - Org Name:BOCA PHARMACY & HOME HEALTH CENTER #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:GRABER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-391-6336
Mailing Address - Street 1:22191 POWERLINE RD
Mailing Address - Street 2:SUITE 22C
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5037
Mailing Address - Country:US
Mailing Address - Phone:561-391-6336
Mailing Address - Fax:561-391-7537
Practice Address - Street 1:22191 POWERLINE RD
Practice Address - Street 2:SUITE 22C
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5037
Practice Address - Country:US
Practice Address - Phone:561-391-6336
Practice Address - Fax:561-391-7537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH181493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1093931OtherNCPDP
FLP8161OtherBLUE CROSS FLORIDA
FL4253350001Medicare ID - Type Unspecified