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General NPI Number Information
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NPI Number | 1578860276
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Entity Type | Organization
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Legal Business Name | 21 PHARMACY INC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 6105 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5004
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Country | US
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Telephone | 305-261-2220
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Fax | 305-261-2290
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Provider Business Mailing Address
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Address Line | 6105 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5004
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Country | US
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Telephone | 305-261-2220
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Fax | 305-261-2290
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | ODALYS CORRALES
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Credential |
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Telephone | 305-261-2220
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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 | PH25327
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License Number State | FL
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