Organization
VITAL SHRED
Active
Other names
ATLANTIC PHARMACY & COMPOUNDING
Organization subpart
No
Provider details
NPI number
Authorized official
SERGE FRANCOIS (PHARMACY DIRECTOR)
(954) 366-6519
Entity
Organization
Contact information
Practice address
1000 E ATLANTIC BLVD STE 110, POMPANO BEACH, FL 33060-7459
(954) 366-6519
(954) 366-6523
Mailing address
1000 E ATLANTIC BLVD, STE:110, POMPANO BEACH, FL 33060-7479
(954) 366-6519
(954) 366-6523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24210
FL
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051604
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/06/2009
Last updated
12/16/2009
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