Organization
PROMOD RX, LLC
Active
Parent organization
PROMOD RX, LLC
Other names
Nutrition Direct
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROMOD RX, LLC
Authorized official
KIM TON PHARMD (PHARMACIST IN CHARGE)
(006) 620-5868
Entity
Organization
Contact information
Practice address
2650 SW 145TH AVE, MIRAMAR, FL 33027-6606
(855) 305-8500
(833) 220-7665
Mailing address
2650 SW 145TH AVE, MIRAMAR, FL 33027-6606
(855) 305-8500
(833) 220-7665
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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