Organization
MALABAR PHARMACY LLC
Active
Other names
Malabar Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANKUR SHAH RPH (PHARMACY MANAGER)
(321) 432-0675
Entity
Organization
Contact information
Practice address
930 MALABAR RD SE, STE 1, PALM BAY, FL 32907-3252
(321) 775-0911
(321) 775-0912
Mailing address
930 MALABAR RD SE, STE 1, PALM BAY, FL 32907-3252
(321) 775-0911
(321) 775-0912
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24682
FL
3336C0004X
Compounding Pharmacy
PH24682
FL
3336L0003X
Long Term Care Pharmacy
PH24682
FL
3336S0011X
Specialty Pharmacy
PH24682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5700388
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/16/2010
Last updated
03/31/2015
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