Organization
INDIAN RIVER PHARMACY
Active
Organization
INDIAN RIVER PHARMACY
Active
Other names
INDIAN RIVER INFUSION SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY MICHEAEL DECRESCENZO R.PH. (PRESIDENT)
(772) 567-2557
Entity
Organization
Contact information
Practice address
3719 10TH CT, VERO BEACH, FL 32960-6559
(772) 567-2557
(772) 567-0013
Mailing address
3719 10TH CT, VERO BEACH, FL 32960-6559
(772) 567-2557
(772) 567-0013
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PH19077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001154
NCPDP
FL
Enumeration date
05/16/2007
Last updated
08/22/2020
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