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Organization
KMART
Active
Organization
KMART
Active
Other names
Sears Holdings
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY DAVID BRYANT PHARMD (PHARMACY INTERN)
(954) 438-0705
Entity
Organization
Contact information
Practice address
10501 PINES BLVD, PEMBROKE PINES, FL 33026
(954) 438-8822
Mailing address
10020 SHERIDAN ST, 8309, PEMBROKE PINES, FL 33024-8555
(954) 443-1028
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16466
FL
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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