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General NPI Number Information
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NPI Number | 1730457664
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Entity Type | Organization
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Legal Business Name | PEDMAR PHARMACY AND DISCOUNT
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 922 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3404
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Country | US
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Telephone | 305-836-3376
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Fax | 305-836-5046
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Provider Business Mailing Address
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Address Line | 922 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3404
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Country | US
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Telephone | 305-836-3376
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Fax | 305-836-5046
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. PEDRO JUAN TORRES
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Credential |
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Telephone | 305-836-3376
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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 | PH25695
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License Number State | FL
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