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General NPI Number Information
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NPI Number | 1336561364
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Entity Type | Organization
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Legal Business Name | C&M HEALTHPRO LLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 1530-B W VINE ST
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City | KISSIMMEE
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State | FL
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Zip | 34741
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Country | US
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Telephone | 407-530-4745
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Fax | 407-530-4744
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Provider Business Mailing Address
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Address Line | 1530-B W VINE ST
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City | KISSIMMEE
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State | FL
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Zip | 34741
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Country | US
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Telephone | 407-530-4745
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Fax | 407-530-4744
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Authorized Official
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Title or Position | OWNER
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Name | MR. TAMER GIRGIS
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Credential |
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Telephone | 407-530-4745
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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 |
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