Organization
RR MEDCO LLC
Active
Other names
Health Source Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DI IULIO (MANAGING MEMBER)
(754) 264-7540
Entity
Organization
Contact information
Practice address
100 E SAMPLE RD STE 320, POMPANO BEACH, FL 33064-3554
(754) 264-7540
(754) 222-9389
Mailing address
100 E SAMPLE RD, SUITE 320, POMPANO BEACH, FL 33064-3554
(754) 264-7540
(754) 222-9389
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME53109
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155098
PK
—
Enumeration date
10/19/2015
Last updated
02/22/2016
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