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General NPI Number Information
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NPI Number | 1356626204
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Entity Type | Organization
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Legal Business Name | PINES PHARMACY INC
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 881 E 2ND AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4205
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Country | US
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Telephone | 305-889-0377
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Fax | 305-882-1162
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Provider Business Mailing Address
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Address Line | 881 E 2ND AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4205
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Country | US
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Telephone | 305-889-0377
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Fax | 305-882-1162
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANCISCO BOZA
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Credential |
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Telephone | 305-889-0377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH25280
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License Number State | FL
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