Provider Demographics
NPI:1770853293
Name:MY COMMUNITY PHARMACY OF BOYNTON INC
Entity Type:Organization
Organization Name:MY COMMUNITY PHARMACY OF BOYNTON INC
Other - Org Name:MY BEST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRBRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-512-5462
Mailing Address - Street 1:1050 GATEWAY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8368
Mailing Address - Country:US
Mailing Address - Phone:561-200-4245
Mailing Address - Fax:561-200-4236
Practice Address - Street 1:1050 GATEWAY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8363
Practice Address - Country:US
Practice Address - Phone:561-200-4245
Practice Address - Fax:561-200-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-02
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336S0011X, 3336S0011X
FLPH258683336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133262OtherPK
FL004578100Medicaid