=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356622666
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHARMACY SOLUTION & DISCOUNT CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2011
-----------------------------------------------------
Last Update Date | 07/03/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9716 SW 40TH ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33165-4075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-551-6663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9716 SW 40TH STREET
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33165
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-551-6663
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | MR. MAHER BABOUJIAN
-----------------------------------------------------
Credential | PHARMACY MANAGER
-----------------------------------------------------
Telephone | 305-551-6663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PH25640
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------