Provider Demographics
NPI:1922425750
Name:ENRICHED LIFE PHARMACEUTICALS
Entity Type:Organization
Organization Name:ENRICHED LIFE PHARMACEUTICALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-439-0898
Mailing Address - Street 1:10880 PAPERBARK PL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7534
Mailing Address - Country:US
Mailing Address - Phone:954-439-0898
Mailing Address - Fax:
Practice Address - Street 1:10880 PAPERBARK PL
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-7534
Practice Address - Country:US
Practice Address - Phone:954-439-0898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage