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NPI Code Detail

MEDICARE: OLORUN PHARMACY AND DISCOUNT CORP

MEDICARE: OLORUN PHARMACY AND DISCOUNT CORP
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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPH28748FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12149744OTHERPK

General Provider Information

NPI Number : 1780073494
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLORUN PHARMACY AND DISCOUNT CORP
Provider Business Mailing Address
First Line : 11400 W FLAGLER ST STE 108
Second Line :
City : MIAMI
State : FL
Zip : 33174-4007
Country : US
Telephone Number : 786-631-4561
Fax Number : 786-631-4585
Provider Business Practice Location Address
First Line : 11400 W FLAGLER ST STE 108
Second Line :
City : MIAMI
State : FL
Zip : 33174-4007
Country : US
Telephone Number : 786-631-4561
Fax Number : 786-361-4585
Authorized Official
Title or Position : PRESIDENT
Name : MISAEL RUBIO
Credential : PHARMACIST
Telephone Number : 786-631-4561
Provider Enumeration Date : 01/19/2015
Last Update Date : 06/22/2015

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Directions to “OLORUN PHARMACY AND DISCOUNT CORP ” Practice Location

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