Organization
HUMANA MEDICAL PLAN INC
Active
Other names
HUMANA PHARMACY 47904
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MONROY (MANAGER)
(305) 254-1515
Entity
Organization
Contact information
Practice address
11000 SW 211TH STREET, CUTLER RIDGE, FL 33189
(305) 254-1515
(305) 256-4310
Mailing address
11000 SW 211TH STREET, CUTLER RIDGE, FL 33189
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PH11078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072038
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
08/22/2020
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