Provider Demographics
NPI:1124266549
Name:LIFE WORTH LIVING FOUNDATION INC
Entity type:Organization
Organization Name:LIFE WORTH LIVING FOUNDATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-522-5685
Mailing Address - Street 1:6488 CURRIN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6207
Mailing Address - Country:US
Mailing Address - Phone:407-522-5685
Mailing Address - Fax:407-522-5684
Practice Address - Street 1:6488 CURRIN DR STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6207
Practice Address - Country:US
Practice Address - Phone:407-522-5685
Practice Address - Fax:407-522-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X, 3336L0003X, 333600000X
FLPH236993336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2120901OtherPK
FL6624390001Medicare NSC
FL031807801OtherMEDICAID DME
FL1851683924OtherDME NPI
1047073OtherNCPDP PROVIDER IDENTIFICATION NUMBER