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NPI Code Detail

MEDICARE: ALBA PHARMACY AND DISCOUNT INC

MEDICARE: ALBA PHARMACY AND DISCOUNT 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
13336C0003XCommunity/Retail PharmacyPH28193FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12146443OTHERPK

General Provider Information

NPI Number : 1619382322
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALBA PHARMACY AND DISCOUNT INC
Provider Business Mailing Address
First Line : 918 E 25TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3404
Country : US
Telephone Number : 786-703-4966
Fax Number :
Provider Business Practice Location Address
First Line : 918 E 25TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-3404
Country : US
Telephone Number : 786-703-4966
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GUSTAVO RODRIGUEZ
Credential :
Telephone Number : 786-237-7804
Provider Enumeration Date : 06/23/2014
Last Update Date : 06/23/2014

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Directions to “ALBA PHARMACY AND DISCOUNT INC ” Practice Location

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