Organization
MODERN PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ROSENBAUM CPA ESQ. LL.M. (ATTORNEY, COMPLIANCE OFFICER)
(305) 531-3784
Entity
Organization
Contact information
Practice address
123 ALTON ROAD, MIAMI BEACH, FL 33139-6708
(305) 531-3784
(305) 531-3779
Mailing address
123 ALTON ROAD, MIAMI BEACH, FL 33139-6708
(305) 531-3784
(305) 531-3779
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH18913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025530100
—
FL
05
—
025530101
—
FL
01
—
1097410
NCPDP
FL
Enumeration date
11/06/2006
Last updated
06/28/2024
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