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NPI Code Detail

MEDICARE: THE HOUSE PHARMACY, INC

MEDICARE: THE HOUSE 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
13336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1STATEOTHERFL26716

General Provider Information

NPI Number : 1831400282
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HOUSE PHARMACY, INC
Provider Business Mailing Address
First Line : 1554 W 68TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33014-3810
Country : US
Telephone Number : 305-821-1275
Fax Number : 305-821-1315
Provider Business Practice Location Address
First Line : 1554 W 68TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33014-3810
Country : US
Telephone Number : 305-821-1275
Fax Number : 305-821-1315
Authorized Official
Title or Position : PRESIDENT
Name : MR. ADRIAN VELAZCO
Credential :
Telephone Number : 305-821-1275
Provider Enumeration Date : 06/30/2010
Last Update Date : 06/30/2010

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Directions to “THE HOUSE PHARMACY, INC ” Practice Location

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