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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