| NPI | 1467530873 |
|---|---|
| Doing Business As | LIFE EXTENSION PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | MELANIE KAMBURIAN Paralegal 954-202-7729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH22301) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2015-03-04 |