MEDICARE: DUBLIN PHARMACY & DISCOUNT, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1184651416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUBLIN PHARMACY & DISCOUNT, INC

Provider Business Mailing Address
First Line	:	491 HIALEAH DR
Second Line	:	2
City	:	HIALEAH
State	:	FL
Zip	:	33010-5335
Country	:	US
Telephone Number	:	305-888-0292
Fax Number	:

Provider Business Practice Location Address
First Line	:	491 HIALEAH DR
Second Line	:	2
City	:	HIALEAH
State	:	FL
Zip	:	33010-5335
Country	:	US
Telephone Number	:	305-888-0292
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HECTOR ROQUE
Credential	:
Telephone Number	:	786-251-3008

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	11/19/2007

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