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Organization

AT YOUR SERVICE PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VALANTINA B MORANCY-CALDERON RPH, BCMTMS, CPH (PRESIDENT/OWNER)
(561) 319-5634
Entity
Organization

Contact information

Practice address
692 SW PRIMA VISTA BLVD, PORT SAINT LUCIE, FL 34983-1835
(305) 528-6539
Mailing address
2002 SW GRANT AVE, PORT SAINT LUCIE, FL 34953-1025
(305) 528-6539

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
3336M0003X
Managed Care Organization Pharmacy
3336S0011X
Specialty Pharmacy
335G00000X
Medical Foods Supplier

Other

Enumeration date
03/07/2021
Last updated
03/07/2021
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