Organization
WEST PALM PHARMACY LLC
Active
Other names
West Palm Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SALIM SOUFAN RPH (PHARMACIST/OWNER)
(561) 249-2130
Entity
Organization
Contact information
Practice address
5760 OKEECHOBEE BLVD, WEST PALM BEACH, FL 33417-4343
(561) 249-2130
(561) 249-2104
Mailing address
5760 OKEECHOBEE BLVD, WEST PALM BEACH, FL 33417-4343
(561) 249-2130
(561) 249-2104
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25847
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5708485
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/23/2011
Last updated
11/29/2012
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