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General NPI Number Information
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NPI Number | 1407877459
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Entity Type | Organization
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Legal Business Name | NOBIS PHARMACY
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 65 NW 167TH ST
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City | N MIAMI BEACH
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State | FL
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Zip | 33169-6017
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Country | US
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Telephone | 305-652-9600
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Fax | 305-652-8833
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Provider Business Mailing Address
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Address Line | PO BOX 170332
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City | HIALEAH
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State | FL
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Zip | 33017-0332
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CELESTINE IZUNOBI
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Credential |
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Telephone | 305-652-9600
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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 | PH13377
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License Number State | FL
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