Organization
BLUE SKY DISCOUNT PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEADRA THORNTON-WRIGHT (OWNER)
(321) 914-0823
Entity
Organization
Contact information
Practice address
115 HICKORY ST, SUITE #101, WEST MELBOURNE, FL 32904-3505
(321) 914-0823
(321) 914-0824
Mailing address
115 HICKORY ST, SUITE #101, WEST MELBOURNE, FL 32904-3505
(321) 914-0823
(321) 914-0824
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH24968
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003753900
—
FL
Enumeration date
11/24/2010
Last updated
03/03/2015
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