PARK SHORE DRUG INC (NPI# 1982653523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982653523 |
| Entity Type | Organization |
| Organization Name | PARK SHORE DRUG INC |
| Practice Address |
600 Ansin Blvd Hallandale Beach FL 33009-2118 |
| Practice Telephone | 9548744646 |
| Practice Fax Number | 9544551378 |
| Mailing Telephone | 9548744646 |
| Mailing Fax Number | 9544551378 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-12-05 |
| Authorized Official Name | MR. ROBERT D GILLIS (PHARMACIST, PRESIDENT) |
| Authorized Official Telephone | 9548744646 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | PH13376 | FL | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
PH13376 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 018614500 | 05 | |
| FL | NCPDP # | 1011915 | 01 |
| FL | MEDICARE LOCAL CARRIER #/PTAN | P1723B | 01 |
| FL | 018477700 | 05 | |
| FL | DME, MEDICAID PHARMACY | 018477701 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386725356 | Park Shore Drug Inc | Pharmacy | 9531 Ne 2nd Ave, Miami Shores, FL 33138-2704 | 2006-10-18 |
| 1063595932 | Park Shore Drug Inc | Durable Medical Equipment & Medical Supplies | 9531 Ne 2nd Ave, Miami Shores, FL 33138-2704 | 2006-10-23 |
| 1285724492 | Park Shore Drug Inc | Durable Medical Equipment & Medical Supplies | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2006-10-16 |
| 1417043100 | Park Shore Drug Inc | Durable Medical Equipment & Medical Supplies | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2006-10-04 |
| Street Address |
600 ANSIN BLVD |
| City | HALLANDALE BEACH |
| State | FL |
| Zip Code | 33009-2118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356957476 | Jessica Michelle Rosales | Pharmacy Technician | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2020-09-23 |
| 1447621198 | Jillian Eve Gillis | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2015-10-07 |
| 1386063220 | Jeanina Diaz | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2014-04-08 |
| 1336570209 | Thomas J Lawley | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2013-12-03 |
| 1871843565 | Emily Marckioli | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2012-09-11 |
| 1952683922 | Kathleen M Hicks | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2011-09-15 |
| 1659653681 | Joanna A Grad | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2011-09-15 |
| 1205118544 | Dawn Michelle Rosales | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2011-09-13 |
| 1235411786 | James M Gillis | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2011-09-11 |
| 1629359245 | Eduardo Lopez IIi | Pharmacist | 600 Ansin Blvd, Hallandale Beach, FL 33009-2118 | 2011-09-09 |
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|---|---|---|---|---|
| 1013499466 | Maia Powell | Doula | 634 Nw 4th Court, Hallandale Beach, FL 33009 | 2018-09-02 |
| 1578057188 | War Network LLC | Clinic/Center | 137 Se 1st Ave, Hallandale Beach, FL 33009 | 2018-06-18 |
| 1700378742 | Vip Cardiology Center LLC | Family Medicine | 2500 E Hallandale Beach Blvd Ste 207, Hallandale Beach, FL 33009 | 2018-06-05 |
| 1831681055 | Ssd Mobility, LLC | Durable Medical Equipment & Medical Supplies | 1000 W Pembrooke Rd, Suite 303, Hallandale Beach, FL 33009 | 2018-06-04 |
| 1366943466 | Imed Advisory LLC | General Practice | 2100 E Hallandale Beach Blvd Ste 402, Hallandale Beach, FL 33009 | 2018-02-23 |
| 1891164059 | Raphael Arwas | Dentist | 1440 E. Hallandale Beach Blvd, Hallandale, FL 33009 | 2015-09-17 |
| 1083092746 | Florida Good Faith Investors LLC. | Non-emergency Medical Transport (VAN) | 1001 N Federal Hwy,ste 246, Suite 349, Hallandale Beach, FL 33009 | 2015-05-14 |
| 1235534058 | Aventura Open Mri, Inc | Clinic/Center | 815 Se 1st Avenue, Suite B, Hallandale, FL 33009 | 2014-10-23 |
| 1437578549 | Beach Club Adult Center, LLC | Clinic/Center | 2500 Hallandale Blvd, Suite T, Hallandale Beach, FL 33009 | 2014-04-16 |
| 1093142747 | Grace Maher Reynolds | Internal Medicine | 1849 South Ocean Dr. Pts 911, Hallandale Beach, FL 33009 | 2013-09-26 |
| Find all providers in zip 33009 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| City | HALLANDALE BEACH |
| Zip Code | 33009 |
Please comment or provide details below to improve the information on PARK SHORE DRUG INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.