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General NPI Number Information
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NPI Number | 1558349233
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Entity Type | Organization
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Legal Business Name | MY PHARMACY OF HOMESTEAD INC
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 806 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4407
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Country | US
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Telephone | 305-247-6949
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Fax | 305-246-0742
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Provider Business Mailing Address
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Address Line | 806 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4407
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Country | US
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Telephone | 305-247-6949
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Fax | 305-246-0742
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Authorized Official
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Title or Position | OWNER
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Name | MR. MURALI KRISHNA KOTHURI
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Credential | RPH
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Telephone | 305-247-6949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH10256
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH10256
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PH10256
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH10256
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH10256
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH10256
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License Number State | FL
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