Organization
DELTONA MEDICAL ARTS PHARMACY INC
Active
Other names
TOWN CENTER PHARMACY - DELTONA
Organization subpart
No
Provider details
NPI number
Authorized official
MUKESH AMIN (PRESIDENT)
(386) 774-7933
Entity
Organization
Contact information
Practice address
1200 DELTONA BLVD, SUITE 50, DELTONA, FL 32725-6306
(386) 259-4712
(386) 259-4712
Mailing address
1200 DELTONA BLVD, SUITE 50, DELTONA, FL 32725-6306
(386) 259-4712
(386) 259-4712
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31105
FL
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177518
PK
—
05
—
711979
—
FL
Enumeration date
01/02/2018
Last updated
07/19/2018
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