Organization
PARK SHORE DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT D GILLIS R.PH. (V.P.)
(305) 754-9508
Entity
Organization
Contact information
Practice address
9531 NE 2ND AVE, MIAMI SHORES, FL 33138-2704
(305) 754-9508
(305) 754-3512
Mailing address
9531 NE 2ND AVE, MIAMI SHORES, FL 33138-2704
(305) 754-9508
(305) 754-3512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PH0000863
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671982104
—
FL
Enumeration date
10/23/2006
Last updated
07/19/2010
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