Healthcare Provider Details

I. General information

NPI: 1457656498
Provider Name (Legal Business Name): MEF PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10468 TAFT ST
PEMBROKE PINES FL
33026-2819
US

IV. Provider business mailing address

10468 TAFT ST
PEMBROKE PINES FL
33026-2819
US

V. Phone/Fax

Practice location:
  • Phone: 954-404-8025
  • Fax: 954-404-8187
Mailing address:
  • Phone: 954-404-8025
  • Fax: 954-404-8187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH26027
License Number StateFL

VIII. Authorized Official

Name: MARTIN PEREZ
Title or Position: OWNER
Credential:
Phone: 954-404-8025