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Organization
POLYPILL COMPOUND MEDICATIONS LLC
Active
Organization
POLYPILL COMPOUND MEDICATIONS LLC
Active
Other names
Polypill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES JACKSON (VP BUSINESS DEVELOPMENT)
(407) 920-1155
Entity
Organization
Contact information
Practice address
4401 SHERIDAN ST STE B, HOLLYWOOD, FL 33021-3513
(855) 765-9745
(866) 355-0176
Mailing address
5701 SW 134TH AVE, SOUTHWEST RANCHES, FL 33330-3100
(407) 920-1155
(407) 540-9614
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH25791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5709398
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/11/2011
Last updated
11/01/2012
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