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MR. BRUCE STANLEY BLACK R PH
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1871831875
Individual Registrant:MR. BRUCE STANLEY BLACK R PH
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
402 E DANIA BEACH BLVD DANIA BEACH, FL 33004-3040 US
Tel: 954-920-7660 Fax: 954-920-7660
Tel: 954-920-7660 Fax: 954-920-7660
Contact information for business:
402 E DANIA BEACH BLVD DANIA BEACH, FL 33004-3040 US
Tel: 954-920-7660 Fax: 954-920-7660
Tel: 954-920-7660 Fax: 954-920-7660
Registration Information:
NPI: 1871831875
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | FL | PS13435 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
