Provider Demographics
NPI:1851683924
Name:LIFE WORTH LIVING FOUNDATION
Entity Type:Organization
Organization Name:LIFE WORTH LIVING FOUNDATION
Other - Org Name:DBA LIFE WORTH LIVING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AYOTUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:407-522-5685
Mailing Address - Street 1:6488 CURRIN DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6207
Mailing Address - Country:US
Mailing Address - Phone:407-522-5685
Mailing Address - Fax:407-522-5684
Practice Address - Street 1:6488 CURRIN DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6207
Practice Address - Country:US
Practice Address - Phone:407-522-5685
Practice Address - Fax:407-522-5684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE WORTH LIVING FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-09
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPS31437332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1047073OtherNCPDP
FL031807801Medicaid
6624390001Medicare NSC