Provider Demographics
NPI:1134437403
Name:EMERALD HILLS PHARMACY LLC
Entity type:Organization
Organization Name:EMERALD HILLS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-983-3336
Mailing Address - Street 1:3000 STIRLING RD
Mailing Address - Street 2:STE 120
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 STIRLING RD
Practice Address - Street 2:STE 120
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2069
Practice Address - Country:US
Practice Address - Phone:954-983-3336
Practice Address - Fax:954-985-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH248733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy