Organization
HUMANA MEDICAL PLAN INC
Active
Other names
HUMANA PHARMACY 47909
Organization subpart
No
Provider details
NPI number
Authorized official
RAY FLOYD (MANAGER)
(954) 321-7888
Entity
Organization
Contact information
Practice address
6971 W SUNRISE BLVD, PLANTATION, FL 33313-4407
(954) 321-7888
(954) 321-7884
Mailing address
6971 W SUNRISE BLVD, PLANTATION, FL 33313-4407
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
PH10250
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073953
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/22/2006
Last updated
08/22/2020
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