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General NPI Number Information
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NPI Number | 1053687798
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Entity Type | Organization
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Legal Business Name | G.M.G PHARMACY AND DISCOUNT
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 2215 W 4TH AVE SUITE E
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City | HIALEAH
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State | FL
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Zip | 33010-1419
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Country | US
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Telephone | 786-558-8880
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Fax | 786-558-8838
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Provider Business Mailing Address
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Address Line | 2215 W 4TH AVE SUITE E
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City | HIALEAH
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State | FL
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Zip | 33010-1419
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Country | US
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Telephone | 786-558-8880
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Fax | 786-558-8838
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Authorized Official
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Title or Position | OWNER
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Name | MS. HOIRIS M MANRIQUE
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Credential |
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Telephone | 786-558-8880
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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 | PH26024
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License Number State | FL
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