Provider Demographics
NPI:1801179163
Name:MARGOLIS, HERBERT G (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:G
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21290 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2435
Mailing Address - Country:US
Mailing Address - Phone:561-368-5759
Mailing Address - Fax:561-362-6530
Practice Address - Street 1:21290 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2435
Practice Address - Country:US
Practice Address - Phone:561-368-5759
Practice Address - Fax:561-362-6530
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist