Provider Demographics
NPI:1972564276
Name:UNITED STATES PHARMACEUTICAL GROUP LLC
Entity Type:Organization
Organization Name:UNITED STATES PHARMACEUTICAL GROUP LLC
Other - Org Name:CONVEY HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-903-5000
Mailing Address - Street 1:13621 NW 12TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2945
Mailing Address - Country:US
Mailing Address - Phone:954-903-5000
Mailing Address - Fax:954-903-5290
Practice Address - Street 1:13621 NW 12TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2846
Practice Address - Country:US
Practice Address - Phone:954-903-5000
Practice Address - Fax:954-903-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH18717332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031372600Medicaid
1096468OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL031372601Medicaid
4249230001Medicare NSC