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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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