Provider Demographics
NPI:1154370369
Name:MAIL ORDER MEDS OF FLORIDA, LLC
Entity type:Organization
Organization Name:MAIL ORDER MEDS OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHABEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-870-5129
Mailing Address - Street 1:4500 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3227
Mailing Address - Country:US
Mailing Address - Phone:888-368-6405
Mailing Address - Fax:
Practice Address - Street 1:4500 BISCAYNE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3227
Practice Address - Country:US
Practice Address - Phone:888-368-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 18786333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1097129OtherNCPDP PROVIDER ID
BM8018182OtherDEA REGISTRATION NUMBER
FL4621920001Medicare NSC