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General NPI Number Information
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NPI Number | 1215191952
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Entity Type | Organization
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Legal Business Name | MAGNA EMPIRE GROUP INC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 2406 SW 137TH AVE 2406 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-6311
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Country | US
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Telephone | 305-227-1174
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Fax | 305-227-1171
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Provider Business Mailing Address
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Address Line | 2406 SW 137TH AVE 2406 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-6311
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Country | US
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Telephone | 305-227-1174
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Fax | 305-227-1171
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Authorized Official
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Title or Position | PRES
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Name | NOHARI MARTINEZ
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Credential | BA
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Telephone | 305-227-1174
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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 | PH23405
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License Number State | FL
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