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NPI Code Detail

MEDICARE: COUNTRY WALK PHARMACY

MEDICARE: COUNTRY WALK PHARMACY
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
1333600000XPharmacyPH21332FL
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11096999OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1801801410
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTRY WALK PHARMACY
Provider Business Mailing Address
First Line : 1845 NW 17TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33125-2330
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1845 NW 17TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33125-2330
Country : US
Telephone Number : 305-325-0301
Fax Number : 305-278-7600
Authorized Official
Title or Position : ADMIN
Name : ELSA RUIZ
Credential :
Telephone Number : 305-325-0301
Provider Enumeration Date : 07/30/2006
Last Update Date : 09/11/2025

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Directions to “COUNTRY WALK PHARMACY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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