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Organization

GATUS ENTERPRISE, PLLC

Active
Other names
BROADWAY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH K APPIAHENE PHARM. D (OWNER)
(407) 750-5999
Entity
Organization

Contact information

Practice address
22 BROADWAY, KISSIMMEE, FL 34741-5408
(407) 750-5999
(407) 750-5002
Mailing address
22 BROADWAY, KISSIMMEE, FL 34741-5408
(407) 750-5999
(407) 750-5002

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH31537
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH31537
PHARMACY LICENSE
FL
Enumeration date
07/17/2018
Last updated
12/21/2018
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