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General NPI Number Information
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NPI Number | 1861831745
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Entity Type | Organization
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Legal Business Name | NUR CORPORATION
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 419 E MICHIGAN ST STE 4
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City | ORLANDO
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State | FL
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Zip | 32806-4511
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Country | US
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Telephone | 407-286-2964
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 S CHICKASAW TRL #146
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City | ORLANDO
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State | FL
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Zip | 32825-8414
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Country | US
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Telephone | 321-251-1837
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SUSAN BALKARAN
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Credential | RPH, CPH
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Telephone | 321-251-1837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH26787
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH26787
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License Number State | FL
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