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General NPI Number Information
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NPI Number | 1033521828
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Entity Type | Organization
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Legal Business Name | FOREVER PHARMACY CORP
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 710 SW 17TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-5231
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Country | US
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Telephone | 305-456-7625
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Fax | 786-558-8392
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Provider Business Mailing Address
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Address Line | 710 SW 17TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-5231
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Country | US
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Telephone | 305-456-7625
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Fax | 786-558-8392
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE MOYA
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Credential |
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Telephone | 305-456-7625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | FL
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