Healthcare Provider Details

I. General information

NPI: 1558639385
Provider Name (Legal Business Name): GALAXY PHARMACY & DISCOUNT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2011
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W FLAGLER ST STE D
MIAMI FL
33130-1174
US

IV. Provider business mailing address

900 W FLAGLER ST SUITE # D
MIAMI FL
33130-1173
US

V. Phone/Fax

Practice location:
  • Phone: 786-362-6390
  • Fax: 786-362-6357
Mailing address:
  • Phone: 786-362-6390
  • Fax: 786-362-6357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number25820
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANGELINA GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-362-6390