Organization
DISCOUNT PHARMACY OF PINES LLC
Active
Organization
DISCOUNT PHARMACY OF PINES LLC
Active
Other names
Discount Pharmacy of Pines LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN TRUXELL (OWNER)
(954) 817-3577
Entity
Organization
Contact information
Practice address
12201 PEMBROKE RD, PEMBROKE PINES, FL 33025-1725
(954) 885-4285
(866) 232-2143
Mailing address
12201 PEMBROKE RD, PEMBROKE PINES, FL 33025-1725
(954) 885-4285
(866) 232-2143
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01359000
—
FL
01
—
1043405
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/02/2009
Last updated
06/07/2011
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