Organization
SOUTHERN RX LLC
Active
Other names
Bellevue Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN ALAN MORDIS PHARM D (PHARMACIST IN CHARGE)
(954) 298-1736
Entity
Organization
Contact information
Practice address
10131 W COMMERCIAL BLVD, SUNRISE, FL 33351-4327
(954) 722-8111
(954) 722-8222
Mailing address
10131 W COMMERCIAL BLVD, SUNRISE, FL 33351-4327
(954) 722-8111
(954) 722-8222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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