Healthcare Provider Details

I. General information

NPI: 1982061255
Provider Name (Legal Business Name): CUE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST SUITE 120
HIALEAH FL
33013-3825
US

IV. Provider business mailing address

777 E 25TH ST SUITE 120
HIALEAH FL
33013-3825
US

V. Phone/Fax

Practice location:
  • Phone: 305-696-5464
  • Fax: 305-696-5191
Mailing address:
  • Phone: 305-696-5464
  • Fax: 305-696-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH29791
License Number StateFL

VIII. Authorized Official

Name: JORGE SANTANA
Title or Position: VP
Credential:
Phone: 305-696-5464