| NPI | 1346647005 |
|---|---|
| Former Legal Business Name | F/K/A MEDOZ PHARMACY OF POLK INC |
| Entity Type | Organization |
| Authorized Contact | ABRAHAM MERMELSTEIN Managing Member 732-267-7782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH28722) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PS28722) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH28722) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2022-08-25 |