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General NPI Number Information
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NPI Number | 1588033112
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Entity Type | Organization
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Legal Business Name | SIR CHARLES PHARMACY, INC.
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 17560 NW 27TH AVE SUITE 119
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4014
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Country | US
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Telephone | 305-705-3415
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Fax |
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Provider Business Mailing Address
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Address Line | 17560 NW 27TH AVE SUITE 119
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4014
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Country | US
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Telephone | 305-705-3415
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. CHARLES AYEBAH
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Credential | PHARMACIST
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Telephone | 954-253-1036
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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 |
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License Number State |
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