Provider Demographics
NPI:1396837902
Name:FFP LLC
Entity type:Organization
Organization Name:FFP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-385-7322
Mailing Address - Street 1:855 SW 78TH AVE STE C-101
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3223
Mailing Address - Country:US
Mailing Address - Phone:954-385-7322
Mailing Address - Fax:954-385-7324
Practice Address - Street 1:855 SW 78TH AVE STE C-101
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3223
Practice Address - Country:US
Practice Address - Phone:954-385-7322
Practice Address - Fax:954-385-7324
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FFP HOLDCO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-29
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH17628333600000X, 3336C0003X, 3336S0011X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100046664Medicaid
TN1508622Medicaid
ID1396837902Medicaid
IN200979200AMedicaid
ME1871670000Medicaid
OH2213296Medicaid
FLPH17628OtherPHARMACY LICENSE
FL022501100Medicaid
SC7F7628Medicaid
MT0212875Medicaid