Organization
DELRAY SHORES PHARMACY INC
Active
Other names
DELRAY SHORES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DILDINE PHARMD (PRESIDENT, PIC)
(561) 272-2124
Entity
Organization
Contact information
Practice address
124 NE 5TH AVE, DELRAY BEACH, FL 33483
(561) 272-2124
(561) 272-2830
Mailing address
124 NE 5TH AVE, DELRAY BEACH, FL 33483-5429
(561) 272-2124
(561) 272-2830
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH6174
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103438300
—
FL
01
—
2009655
PK
—
Enumeration date
11/03/2006
Last updated
11/24/2020
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