Provider Demographics
NPI:1851844732
Name:STAYWELL PHARMACY & MEDICAL SUPPLY
Entity Type:Organization
Organization Name:STAYWELL PHARMACY & MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARCOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-309-6836
Mailing Address - Street 1:5820 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1527
Mailing Address - Country:US
Mailing Address - Phone:954-309-6836
Mailing Address - Fax:
Practice Address - Street 1:5820 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1527
Practice Address - Country:US
Practice Address - Phone:954-309-6836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies