Organization
E & T PHARMACY LLC
Active
Other names
COASTAL COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EPHREM DEGEFU RPH (PHCY MANAGER)
(561) 683-1095
Entity
Organization
Contact information
Practice address
3111 45TH ST STE 3, WEST PALM BEACH, FL 33407-1981
(561) 683-1095
(561) 683-0591
Mailing address
3111 45TH ST STE 3, WEST PALM BEACH, FL 33407-1981
(561) 683-1095
(561) 683-0591
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH22257
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007665
PK
—
Enumeration date
10/12/2006
Last updated
06/20/2016
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