Provider Demographics
NPI:1356719074
Name:ALL HEART PHARMACY INC
Entity type:Organization
Organization Name:ALL HEART PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:RASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENODA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-654-4760
Mailing Address - Street 1:911 SE 6TH AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5190
Mailing Address - Country:US
Mailing Address - Phone:561-654-4760
Mailing Address - Fax:
Practice Address - Street 1:911 SE 6TH AVE
Practice Address - Street 2:STE 105
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5190
Practice Address - Country:US
Practice Address - Phone:561-654-4760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7575970001Medicare NSC