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General NPI Number Information
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NPI Number | 1366750473
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Entity Type | Organization
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Legal Business Name | KEZIT DISCOUNT PHARMACY
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 12813 W DIXIE HWY
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4807
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Country | US
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Telephone | 305-456-6844
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Fax | 305-456-5854
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Provider Business Mailing Address
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Address Line | 12813 W DIXIE HWY
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City | NORTH MIAMI
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State | FL
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Zip | 33161-4807
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Country | US
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Telephone | 305-456-6844
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Fax | 305-456-5854
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Authorized Official
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Title or Position | PHARMACIST
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Name | FABIAN ONWUANA IGWE
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Credential |
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Telephone | 786-301-4563
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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 | PH24905
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License Number State | FL
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