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General NPI Number Information
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NPI Number | 1962804625
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Entity Type | Organization
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Legal Business Name | IGR PHARMACY CORP
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 6045 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5039
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Country | US
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Telephone | 786-401-7020
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Fax | 786-401-7042
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Provider Business Mailing Address
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Address Line | 6045 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5039
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Country | US
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Telephone | 786-401-7020
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Fax | 786-401-7042
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Authorized Official
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Title or Position | PRESIDENT
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Name | ILEANA ROJAS
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Credential |
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Telephone | 786-401-7020
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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 |
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License Number State | FL
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