Provider Demographics
NPI:1174808125
Name:PATIENTS CHOICE PHARMACY LLC
Entity type:Organization
Organization Name:PATIENTS CHOICE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:954-661-2488
Mailing Address - Street 1:4801 S UNIVERSITY DR STE 105
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3835
Mailing Address - Country:US
Mailing Address - Phone:954-622-2222
Mailing Address - Fax:954-622-2223
Practice Address - Street 1:4801 S UNIVERSITY DR STE 105
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3835
Practice Address - Country:US
Practice Address - Phone:954-622-2222
Practice Address - Fax:954-622-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X
FLPH256313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132633OtherPK
FL005449200Medicaid