Organization
CORAL GABLES PHARMACY AND MEDICAL SUPPLY, INC
Active
Other names
Coral Gables Pharmacy and Medical Supply, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PAEZ (PHARMACY MANAGER)
(305) 444-5115
Entity
Organization
Contact information
Practice address
3160 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-6826
(305) 444-5115
(305) 444-5119
Mailing address
3160 PONCE DE LEON BLVD, CORAL GABLES, FL 33134-6826
(305) 444-5115
(305) 444-5119
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25066
FL
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5702786
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/23/2010
Last updated
11/23/2010
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