MEDICARE: CITY PHARMACY & 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
1	3336C0003X	Community/Retail Pharmacy	PH24562	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5700287	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1821314196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY PHARMACY & DISCOUNT CORP

Provider Business Mailing Address
First Line	:	923 SW 122ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-2477
Country	:	US
Telephone Number	:	305-200-3898
Fax Number	:	305-200-5837

Provider Business Practice Location Address
First Line	:	923 SW 122ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-2477
Country	:	US
Telephone Number	:	305-200-3898
Fax Number	:	305-200-5837

Authorized Official
Title or Position	:	PRESIDENT / OWNER
Name	:	RICARDO BATISTA-SANCHEZ
Credential	:
Telephone Number	:	305-200-3898

Provider Enumeration Date	:	04/12/2010
Last Update Date	:	06/03/2010

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