Healthcare Provider Details

I. General information

NPI: 1154646800
Provider Name (Legal Business Name): CMA MEDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NE 125TH ST
NORTH MIAMI FL
33161-5032
US

IV. Provider business mailing address

1190 NE 125TH ST
NORTH MIAMI FL
33161-5032
US

V. Phone/Fax

Practice location:
  • Phone: 305-891-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberME88821
License Number StateFL

VIII. Authorized Official

Name: MARY CHEN
Title or Position: ADMINISTRATION
Credential:
Phone: 305-621-0023