Organization
MILLENNIUM SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAM TU (PHARMACIST/OWNER)
(407) 616-1327
Entity
Organization
Contact information
Practice address
110 S ORLANDO AVE STE 5, WINTER PARK, FL 32789-3656
(407) 616-1327
Mailing address
110 S ORLANDO AVE STE 5, WINTER PARK, FL 32789-3656
(407) 616-1327
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH30593
FL
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167636
PK
—
Enumeration date
01/31/2017
Last updated
02/20/2017
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