Organization
POLYPILL COMPOUND MEDICATIONS LLC
Active
Other names
Polypill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES JACKSON (VP BUSINESS DEVELOPMENT)
(407) 920-1155
Entity
Organization
Contact information
Practice address
4401 SHERIDAN ST STE B, HOLLYWOOD, FL 33021-3513
(855) 765-9745
(866) 355-0176
Mailing address
5701 SW 134TH AVE, SOUTHWEST RANCHES, FL 33330-3100
(407) 920-1155
(407) 540-9614
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH25791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5709398
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/11/2011
Last updated
11/01/2012
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