Provider Demographics
NPI:1912413741
Name:ORANGE TREE PHARMACY INC.
Entity Type:Organization
Organization Name:ORANGE TREE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROURKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-625-2773
Mailing Address - Street 1:6191 ORANGE DR STE 6177
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3450
Mailing Address - Country:US
Mailing Address - Phone:954-625-2773
Mailing Address - Fax:954-625-2774
Practice Address - Street 1:6191 ORANGE DR STE 6177
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3450
Practice Address - Country:US
Practice Address - Phone:954-900-5174
Practice Address - Fax:954-900-5276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-15
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy