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General NPI Number Information
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NPI Number | 1881770139
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Entity Type | Organization
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Legal Business Name | MELI PHARMACY & SUPPLIES INC
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Dates
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Enumeration Date | 10/30/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 1432 EAST 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010
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Country | US
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Telephone | 305-863-7211
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Fax | 305-863-7249
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Provider Business Mailing Address
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Address Line | 1432 EAST 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010
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Country | US
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Telephone | 305-863-7211
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Fax | 305-863-7249
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. ELIADES PENA ALCOLEA
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Credential |
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Telephone | 305-863-7211
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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 | PH 20954
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH20954
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License Number State | FL
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