Organization
BLUE RIVER HQ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY RAHEMI PTA (OFFICE MANAGER)
(269) 501-7034
Entity
Organization
Contact information
Practice address
1394 US HIGHWAY 1, VERO BEACH, FL 32960-5732
(269) 501-7034
Mailing address
1965 NEWMARK CIR SW, VERO BEACH, FL 32968-6711
(269) 501-7034
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
FL
3336C0004X
Compounding Pharmacy
—
FL
Other
Enumeration date
04/18/2015
Last updated
04/18/2015
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