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General NPI Number Information
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NPI Number | 1811254618
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Entity Type | Organization
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Legal Business Name | MEDICINE PHARMACY
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 710 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4318
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Country | US
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Telephone | 305-364-5083
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Fax | 786-558-8373
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Provider Business Mailing Address
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Address Line | 710 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4318
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Country | US
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Telephone | 305-364-5083
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Fax | 786-558-8373
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRETA PELEGRIN
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Credential |
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Telephone | 305-310-9327
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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 | PH25911
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License Number State | FL
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