Organization
GENERIC USA PHAMRACY INC
Active
Organization
GENERIC USA PHAMRACY INC
Active
Other names
Generic USA Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY FRER (PRESIDENT)
(954) 200-6011
Entity
Organization
Contact information
Practice address
6401 N UNIVERSITY DR, TAMARAC, FL 33321-4048
(954) 200-6011
Mailing address
6401 N UNIVERSITY DR, TAMARAC, FL 33321-4048
(954) 200-6011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5706138
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2011
Last updated
06/13/2011
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