MEDICARE: OK PHARMACY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH20855	FL

General Provider Information

NPI Number	:	1033295993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OK PHARMACY, INC

Provider Business Mailing Address
First Line	:	2736 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6638
Country	:	US
Telephone Number	:	305-485-7712
Fax Number	:

Provider Business Practice Location Address
First Line	:	2736 SW 137TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6638
Country	:	US
Telephone Number	:	305-485-7712
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ORIOL TIRADO
Credential	:
Telephone Number	:	305-485-7712

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	09/04/2008

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Directions to “OK PHARMACY, INC ” Practice Location

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