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General NPI Number Information
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NPI Number | 1629345970
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Entity Type | Organization
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Legal Business Name | CYM PHARMACY CORP
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 11338 SW 184TH ST
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City | MIAMI
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State | FL
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Zip | 33157-6553
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Country | US
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Telephone | 305-234-3294
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Fax | 305-234-3394
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Provider Business Mailing Address
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Address Line | 11338 SW 184TH ST
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City | MIAMI
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State | FL
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Zip | 33157-6553
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Country | US
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Telephone | 305-234-3294
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Fax | 305-234-3394
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JESUS LLANOSA
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Credential |
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Telephone | 305-234-3294
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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 | PH25802
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License Number State | FL
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