MEDICARE: AMBAR RX 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		FL

General Provider Information

NPI Number	:	1538586615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBAR RX INC

Provider Business Mailing Address
First Line	:	6460 SW 8TH ST
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-4814
Country	:	US
Telephone Number	:	786-703-3388
Fax Number	:	786-703-3390

Provider Business Practice Location Address
First Line	:	6460 SW 8TH ST
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-4814
Country	:	US
Telephone Number	:	786-703-3388
Fax Number	:	786-703-3390

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YADELMIS MARZABAL
Credential	:
Telephone Number	:	786-703-3388

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	03/26/2014

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