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General NPI Number Information
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NPI Number | 1689951808
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Entity Type | Organization
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Legal Business Name | BIRD GALLOWAY HEALTH LLC
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 7035 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33173-2505
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Country | US
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Telephone | 786-422-8302
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Fax | 786-456-7135
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Provider Business Mailing Address
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Address Line | 20900 NE 30TH AVE STE 303
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City | AVENTURA
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State | FL
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Zip | 33180-2162
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Country | US
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Telephone | 305-370-3540
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Fax | 305-935-1729
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Authorized Official
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Title or Position | EXECUTIVE GENERAL MANAGER
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Name | ARI LEVY
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Credential | PHARM D
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Telephone | 786-422-7313
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH25837
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License Number State | FL
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