Provider Demographics
NPI:1962573972
Name:PHARMA EXPRESS INC
Entity type:Organization
Organization Name:PHARMA EXPRESS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-219-7212
Mailing Address - Street 1:777 SHOTGUN RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1940
Mailing Address - Country:US
Mailing Address - Phone:954-210-7774
Mailing Address - Fax:800-219-7213
Practice Address - Street 1:777 SHOTGUN RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1940
Practice Address - Country:US
Practice Address - Phone:954-210-7774
Practice Address - Fax:800-219-7213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH15613333600000X
CT00028983336C0003X
TX289333336C0003X
NJ28RO000883003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2011032OtherPK