Organization
WESTSIDE PHARMACY LLC
Active
Other names
WESTSIDE PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BHARATKUMAR PATEL (PHARMACIST/OWNER)
(954) 785-7747
Entity
Organization
Contact information
Practice address
2977 W COMMERCIAL BLVD, FT LAUDERDALE, FL 33309-3502
(954) 484-8474
(954) 484-8475
Mailing address
2977 W COMMERCIAL BLVD, FT LAUDERDALE, FL 33309-3502
(954) 484-8474
(954) 484-8475
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24518
FL
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1054319
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/17/2010
Last updated
08/29/2011
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