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NPI Code Detail

MEDICARE: VANGUARD PHARMACY & DISCOUNT INC

MEDICARE: VANGUARD PHARMACY & 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 PharmacyPH28774FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PH28774OTHERFLFLORIDA BOARD OF PHARMACY

General Provider Information

NPI Number : 1669863924
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANGUARD PHARMACY & DISCOUNT INC
Provider Business Mailing Address
First Line : 2089 SW 67TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33155-1835
Country : US
Telephone Number : 305-262-1266
Fax Number : 305-262-1267
Provider Business Practice Location Address
First Line : 2089 SW 67TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33155-1835
Country : US
Telephone Number : 305-262-1266
Fax Number : 305-262-1267
Authorized Official
Title or Position : PRESIDENT OWNER
Name : MR. ANIEL F CUEVAS
Credential :
Telephone Number : 305-262-1266
Provider Enumeration Date : 02/09/2015
Last Update Date : 02/09/2015

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Directions to “VANGUARD PHARMACY & DISCOUNT INC ” Practice Location

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