Organization
HUMANA MEDICAL PLAN INC
Active
Organization
HUMANA MEDICAL PLAN INC
Active
Other names
HUMANA PHARMACY 47908
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE ROHAUS (MANAGER)
(954) 970-2503
Entity
Organization
Contact information
Practice address
5643 NW 29TH ST, SUITE 120, MARGATE, FL 33063-1531
(954) 970-2503
(954) 970-9839
Mailing address
5643 NW 29TH ST, SUITE 120, MARGATE, FL 33063-1531
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PH10314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073941
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
08/22/2020
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