Healthcare Provider Details

I. General information

NPI: 1518235100
Provider Name (Legal Business Name): CMA PHARMACY & SUPPLIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5549 SW 8 STREET
CORAL GABLES FL
33134
US

IV. Provider business mailing address

5549 SW 8 STREET
CORAL GABLES FL
33134
US

V. Phone/Fax

Practice location:
  • Phone: 305-364-5807
  • Fax: 306-603-8908
Mailing address:
  • Phone: 305-364-5807
  • Fax: 306-603-8908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH25784
License Number StateFL

VIII. Authorized Official

Name: MR. ODALYS AGUILERA
Title or Position: PRESIDENT
Credential:
Phone: 305-364-5807