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NPI Code Detail

MEDICARE: OMG PHARMACY DISCOUNT INC

MEDICARE: OMG 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
1333600000XPharmacyFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14334OTHERFLDOC NUMB

General Provider Information

NPI Number : 1316203524
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMG PHARMACY DISCOUNT INC
Provider Business Mailing Address
First Line : 7305 NW 36TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33166-6704
Country : US
Telephone Number : 305-629-9032
Fax Number : 305-629-9034
Provider Business Practice Location Address
First Line : 7305 NW 36TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33166-6704
Country : US
Telephone Number : 305-629-9032
Fax Number : 305-629-9034
Authorized Official
Title or Position : PRESIDENT
Name : ALAYN BOU
Credential :
Telephone Number : 305-629-9032
Provider Enumeration Date : 04/02/2012
Last Update Date : 04/02/2012

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Directions to “OMG PHARMACY DISCOUNT INC ” Practice Location

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