Organization
ADVANCED RX DERM LLC
Active
Other names
Advanced Rx Pharmacy 027, INTEGRA RX
Organization subpart
No
Provider details
NPI number
Authorized official
PARVINDER S KAINTH (MANAGER)
(407) 753-6310
Entity
Organization
Contact information
Practice address
755 W SR 434 STE B, LONGWOOD, FL 32750-5136
(407) 753-6310
(844) 941-1585
Mailing address
PO BOX 1730, LUTZ, FL 33548-1730
(407) 753-6310
(844) 566-0501
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28614
FL
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/16/2015
Last updated
07/07/2020
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