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General NPI Number Information
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NPI Number | 1902167125
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Entity Type | Organization
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Legal Business Name | ALHAMBRA PHARMACY INC
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 06/05/2012
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Provider Practice Location Address
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Address Line | 4815 NW 79TH AVE STE 1
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City | DORAL
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State | FL
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Zip | 33166-5437
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Country | US
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Telephone | 786-452-1171
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Fax | 786-452-1172
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Provider Business Mailing Address
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Address Line | 4815 NW 79TH AVE STE 1
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City | DORAL
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State | FL
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Zip | 33166-5437
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Country | US
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Telephone | 786-452-1171
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Fax | 786-452-1172
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Authorized Official
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Title or Position | OWNER
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Name | LEONEL HERNANDEZ
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Credential |
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Telephone | 786-452-1171
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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 | PH26180
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License Number State | FL
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