Provider Demographics
NPI:1255539920
Name:AMERICA'S INNOVATIVE PHARMACEUTICAL & HEALTHCARE SERVICES
Entity type:Organization
Organization Name:AMERICA'S INNOVATIVE PHARMACEUTICAL & HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYFUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-439-6789
Mailing Address - Street 1:920 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-3507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4661 NW 31ST AVE
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33309-3405
Practice Address - Country:US
Practice Address - Phone:954-332-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-04
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy