Organization
WINN DIXIE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN M ELLIS PHARM-D (STAFF PHARMACY)
(561) 637-2364
Entity
Organization
Contact information
Practice address
14595 MILITARY TRL, DELRAY BEACH, FL 33484-3730
(561) 637-2364
Mailing address
10004 WINDING LAKE RD APT 102, SUNRISE, FL 33351-5834
(954) 749-3518
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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