Organization
COCOA BEACH DISCOUNT PHARMACY LLC
Active
Organization
COCOA BEACH DISCOUNT PHARMACY LLC
Active
Other names
Cocoa Beach Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HETALBEN PATEL (PHARMACY MANAGER)
(321) 799-2030
Entity
Organization
Contact information
Practice address
291 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3529
(321) 799-2030
(321) 799-2050
Mailing address
291 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3529
(321) 799-2030
(321) 799-2050
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24812
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002760200
—
FL
01
—
5701354
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/16/2010
Last updated
11/02/2010
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