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General NPI Number Information
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NPI Number | 1376849083
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Entity Type | Organization
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Legal Business Name | PARKDALE PHARMACUTICALS CORP
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 6714 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-7544
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Country | US
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Telephone | 954-332-6669
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Fax |
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Provider Business Mailing Address
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Address Line | 247 SW 8TH ST #248
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City | MIAMI
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State | FL
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Zip | 33130-3529
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Country | US
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Telephone | 202-437-6608
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERTO FACEY
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Credential |
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Telephone | 202-437-6608
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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 | PH25213
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License Number State | FL
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