Healthcare Provider Details

I. General information

NPI: 1316320666
Provider Name (Legal Business Name): BUBAIRE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 HIALEAH DR
HIALEAH FL
33010-5541
US

IV. Provider business mailing address

920 HIALEAH DR
HIALEAH FL
33010-5541
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-6845
  • Fax: 786-536-6845
Mailing address:
  • Phone: 786-536-6845
  • Fax: 786-536-6845

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: LESTER RUIZ
Title or Position: PRESIDENT
Credential:
Phone: 786-536-6845