NPIMap

Organization Active NPI

Promod RX, LLC

  • Community/Retail Pharmacy
  • Miramar, FL
National Provider Identifier
1558905661
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PROMOD RX, LLC
Practice address
2650 SW 145TH Ave
Miramar, FL 33027-6606
Phone
(855) 305-8500
Fax
(833) 220-7665
NPI assigned
Oct 31, 2019
Organization subpart
Yes
Parent organization
PROMOD RX, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Ton, PHARMD
Title
Pharmacist in Charge
Phone
(006) 620-5868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2650 SW 145TH Ave
Miramar, FL 33027-6606

Mailing address

2650 SW 145TH Ave
Miramar, FL 33027-6606
Phone (855) 305-8500

Other names 1

  • Nutrition Direct Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promod RX LLC2 organizations share this tax ID, including this one
Part of
Promod RX LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1558905661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 SW 145TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276606",
            "telephone_number": "855-305-8500",
            "fax_number": "833-220-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 SW 145TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276606",
            "telephone_number": "855-305-8500",
            "fax_number": "833-220-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMOD RX, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMOD RX, LLC",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "TON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "006-620-5868",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nutrition Direct",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.