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General NPI Number Information
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NPI Number | 1750473963
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Entity Type | Organization
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Legal Business Name | HYPERDRUG PHARMACY & DISCOUNT STORE INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6410 NW 186 ST
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City | MIAMI LAKES
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State | FL
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Zip | 33015
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Country | US
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Telephone | 305-825-3386
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Fax | 305-825-7918
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Provider Business Mailing Address
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Address Line | 6410 NW 186 ST
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City | MIAMI LAKES
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State | FL
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Zip | 33015
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Country | US
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Telephone | 305-825-3386
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Fax | 305-825-7918
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEO CUERVO
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Credential | RPH
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Telephone | 305-827-9582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH0010393
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License Number State | FL
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