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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