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General NPI Number Information
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NPI Number | 1689757726
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Entity Type | Organization
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Legal Business Name | MORTAR & PESTLE PHARMACY INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 12920 SW 119TH ST
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City | MIAMI
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State | FL
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Zip | 33186-4506
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Country | US
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Telephone | 305-603-9958
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Fax | 305-603-9958
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Provider Business Mailing Address
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Address Line | 12920 SW 119TH ST
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City | MIAMI
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State | FL
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Zip | 33186-4506
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Country | US
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Telephone | 305-603-9958
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Fax | 305-603-9958
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Authorized Official
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Title or Position | PIC
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Name | MERCEDES SILVA
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Credential | BS PHARM RPH
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Telephone | 305-775-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH22625
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License Number State | FL
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