Organization
RR MEDCO LLC
Active
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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