Provider Demographics
NPI:1891807723
Name:UNIVERSITY PHARMACY INC
Entity Type:Organization
Organization Name:UNIVERSITY PHARMACY INC
Other - Org Name:UNIVERSITY PHARMACY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-622-4088
Mailing Address - Street 1:4925 PACIFICO CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8995
Mailing Address - Country:US
Mailing Address - Phone:561-801-2615
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY BLVD
Practice Address - Street 2:STE 108
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2773
Practice Address - Country:US
Practice Address - Phone:561-622-4088
Practice Address - Fax:561-622-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH221873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031703900Medicaid
FL031703900Medicaid
FL031703900Medicaid