Organization
PLANTATION PHARMACY INC
Active
Organization
PLANTATION PHARMACY INC
Active
Other names
The Plantation Pharmacy at Midtown 24
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN DOHERTY (PRESIDENT/PHARMACIST)
(954) 829-5465
Entity
Organization
Contact information
Practice address
700 SW 78TH AVE STE 101, PLANTATION, FL 33324-3313
(954) 473-8441
(954) 473-8443
Mailing address
700 SW 78TH AVE, SUITE 101, PLANTATION, FL 33324-3298
(954) 473-8441
(954) 473-8443
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26171
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5710644
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/31/2012
Last updated
02/01/2013
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