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General NPI Number Information
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NPI Number | 1568638955
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Entity Type | Organization
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Legal Business Name | PHARMAG INC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 9724 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7513
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Country | US
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Telephone | 305-382-3000
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Fax | 305-382-3003
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Provider Business Mailing Address
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Address Line | 9724 SW 24TH ST
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City | MIAMI
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State | FL
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Zip | 33165-7513
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Country | US
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Telephone | 305-382-3000
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Fax | 305-382-3003
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | RAYDEL A LORENZO
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Credential | PHARM.D
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Telephone | 305-382-3000
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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 | PH24660
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License Number State | FL
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