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General NPI Number Information
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NPI Number | 1598130890
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Entity Type | Organization
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Legal Business Name | STAYWELL RX PHARMACY LLC
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 7209 CORAL WAY
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City | MIAMI
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State | FL
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Zip | 33155-1401
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Country | US
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Telephone | 305-262-8297
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Fax | 305-262-8299
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Provider Business Mailing Address
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Address Line | 7209 CORAL WAY
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City | MIAMI
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State | FL
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Zip | 33155-1401
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Country | US
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Telephone | 305-262-8297
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Fax | 305-262-8299
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROLINA LIPMAN
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Credential |
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Telephone | 305-262-8297
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH29503
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License Number State | FL
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