Organization
BALANCEMED LLC
Active
Other names
Mug & Mortar
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT STEVENS (PRESIDENT)
(954) 383-0505
Entity
Organization
Contact information
Practice address
13460 SW 10TH ST, PEMBROKE PINES, FL 33027-1833
(954) 391-7788
Mailing address
229 N LATITUDE CIR, DELRAY BEACH, FL 33483-8060
(954) 383-0505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH 26213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137246
PK
—
Enumeration date
10/05/2012
Last updated
12/22/2015
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