Organization
OMJRB LLC
Active
Other names
MEDICINE STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIMAL PATEL R.PH (OWNER)
(407) 738-0972
Entity
Organization
Contact information
Practice address
2722 W OLD US HIGHWAY 441, MOUNT DORA, FL 32757-3503
(407) 738-0972
(877) 599-6183
Mailing address
2722 W OLD US HIGHWAY 441, MOUNT DORA, FL 32757-3503
(407) 738-0972
(877) 599-6183
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH28791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH28791
PHARMACY LICENSE NUMBER FOR STATE OF FLORIDA
FL
Enumeration date
01/13/2015
Last updated
01/13/2015
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