Provider Demographics
NPI:1669057048
Name:APOTHECO PHARMACY BOCA LLC
Entity type:Organization
Organization Name:APOTHECO PHARMACY BOCA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-869-2820
Mailing Address - Street 1:788 MORRIS TURNPIKE
Mailing Address - Street 2:FL 3
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-869-2820
Mailing Address - Fax:973-869-2822
Practice Address - Street 1:5501 N FEDERAL HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4023
Practice Address - Country:US
Practice Address - Phone:561-560-8022
Practice Address - Fax:561-560-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy