Organization
HOLLYWOOD HEALTHCARE CORP
Active
Other names
LOGIMEDIX
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KUSHER (PRESIDENT)
(954) 349-9551
Entity
Organization
Contact information
Practice address
15851 SW 41ST ST STE 700, DAVIE, FL 33331-1540
(954) 349-9551
(954) 349-9552
Mailing address
15851 SW 41ST ST, #700, DAVIE, FL 33331-1541
(954) 349-9551
(954) 349-9552
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000820400
—
FL
01
—
5707293
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/01/2011
Last updated
09/01/2011
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