Healthcare Provider Details

I. General information

NPI: 1003105859
Provider Name (Legal Business Name): NARANJA DISCOUNT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 07/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26799 S DIXIE HWY
NARANJA FL
33032-7403
US

IV. Provider business mailing address

26799 S DIXIE HWY
NARANJA FL
33032-7403
US

V. Phone/Fax

Practice location:
  • Phone: 305-257-0081
  • Fax: 305-257-0094
Mailing address:
  • Phone: 305-257-0081
  • Fax: 305-257-0094

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 NumberPH25366
License Number StateFL

VIII. Authorized Official

Name: GIDEON NJOKU
Title or Position: MANAGER
Credential:
Phone: 305-257-0081