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NPI Code Detail

MEDICARE: SUSYS PHARMACY INC

MEDICARE: SUSYS 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
13336C0003XCommunity/Retail PharmacyPH28182FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12150360OTHERPK

General Provider Information

NPI Number : 1740672278
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUSYS PHARMACY INC
Provider Business Mailing Address
First Line : 12887 SW 42ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33175-3435
Country : US
Telephone Number : 786-431-5766
Fax Number : 786-431-5751
Provider Business Practice Location Address
First Line : 12887 SW 42ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33175-3435
Country : US
Telephone Number : 786-431-5766
Fax Number : 786-431-5751
Authorized Official
Title or Position : PHARMACY MANAGER
Name : OLURONKE OLUFIDIPE
Credential :
Telephone Number : 786-431-5766
Provider Enumeration Date : 02/20/2015
Last Update Date : 02/15/2017

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Directions to “SUSYS PHARMACY INC ” Practice Location

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