MEDICARE: NOBIS 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	183500000X	Pharmacist	13377	FL

General Provider Information

NPI Number	:	1649332594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOBIS PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 170332
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33017-0332
Country	:	US
Telephone Number	:	305-652-9600
Fax Number	:	305-652-8833

Provider Business Practice Location Address
First Line	:	65 NW 167TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-6017
Country	:	US
Telephone Number	:	305-652-9600
Fax Number	:	305-652-8833

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CELESTINE OGOCHUKWU IZUNOBI
Credential	:	PHARMD
Telephone Number	:	305-652-9600

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/22/2020

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