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NPI Code Detail

MEDICARE: RIVERSIDE COMMUNITY PHARMACY, INC.

MEDICARE: RIVERSIDE COMMUNITY PHARMACY, 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
1333600000XPharmacyPH26403FL
23336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1629320825
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERSIDE COMMUNITY PHARMACY, INC.
Provider Business Mailing Address
First Line : RIVERSIDE COMMUNITY PHARMACY, INC.
Second Line : 1456 NW 17TH AVE
City : MIAMI
State : FL
Zip : 33125
Country : US
Telephone Number : 305-549-6677
Fax Number : 305-549-6633
Provider Business Practice Location Address
First Line : RIVERSIDE COMMUNITY PHARMACY, INC.
Second Line : 1456 NW 17TH AVE
City : MIAMI
State : FL
Zip : 33125
Country : US
Telephone Number : 305-549-6677
Fax Number : 305-549-6633
Authorized Official
Title or Position : ADMINISTRATOR
Name : MICHAEL P GARCIA
Credential :
Telephone Number : 305-549-6677
Provider Enumeration Date : 10/11/2012
Last Update Date : 04/19/2019

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Directions to “RIVERSIDE COMMUNITY PHARMACY, INC. ” Practice Location

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