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General NPI Number Information
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NPI Number | 1548572092
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Entity Type | Organization
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Legal Business Name | NMB GENERICS PHARMACY
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 16600 N MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33169-6026
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Country | US
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Telephone | 305-974-4510
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Fax | 305-454-9748
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Provider Business Mailing Address
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Address Line | 16600 N MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33169-6026
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Country | US
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Telephone | 305-974-4510
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Fax | 305-454-9748
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Authorized Official
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Title or Position | OWNER
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Name | LORIE GRESS
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Credential |
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Telephone | 305-974-4510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | PH24730
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PH24730
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24730
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License Number State | FL
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