Organization
LURDS INC
Active
Other names
DOCTORS CHOICE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARDI VAN RENSBURG RPH (DME OFFICER)
(727) 697-1090
Entity
Organization
Contact information
Practice address
6518 MAIN ST, NEW PORT RICHEY, FL 34653-3905
(727) 844-7040
(727) 842-5845
Mailing address
7455 STATE ROAD 52, BAYONET POINT, FL 34667-6714
(727) 697-1090
(727) 697-1074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH19391
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015772
PK
—
05
—
212547100
—
FL
Enumeration date
09/30/2006
Last updated
03/18/2016
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