Provider Demographics
NPI:1982759510
Name:DRUG PLACE, INC
Entity Type:Organization
Organization Name:DRUG PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-990-2204
Mailing Address - Street 1:2201 W SAMPLE RD
Mailing Address - Street 2:BLDG 9 SUITE 3A
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3056
Mailing Address - Country:US
Mailing Address - Phone:954-990-2204
Mailing Address - Fax:954-990-2205
Practice Address - Street 1:2201 W SAMPLE RD
Practice Address - Street 2:BLDG 9 SUITE 3A
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3056
Practice Address - Country:US
Practice Address - Phone:954-990-2204
Practice Address - Fax:954-990-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH 164273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000194700Medicaid
FL5352000002Medicare NSC