Healthcare Provider Details

I. General information

NPI: 1548669120
Provider Name (Legal Business Name): FORDS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 NW 27TH ST STE 503
DORAL FL
33122-1905
US

IV. Provider business mailing address

8280 NW 27TH ST STE 503
DORAL FL
33122-1905
US

V. Phone/Fax

Practice location:
  • Phone: 305-592-8353
  • Fax: 305-436-1137
Mailing address:
  • Phone: 305-592-8353
  • Fax: 305-436-1137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. LONA SMITH
Title or Position: PRESIDENT
Credential:
Phone: 305-592-8353