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General NPI Number Information
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NPI Number | 1053721738
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Entity Type | Organization
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Legal Business Name | ENUKORA INC
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Dates
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Enumeration Date | 05/02/2014
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 18346 NW 7TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4438
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Country | US
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Telephone | 305-651-4725
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Fax |
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Provider Business Mailing Address
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Address Line | 18346 NW 7TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4438
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Country | US
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Telephone | 305-651-4725
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANEGER
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Name | MR. BONIFACE O ENUKORA
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Credential | PHARMACIST
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Telephone | 305-450-7709
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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 | PH28093
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License Number State | FL
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