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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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