Organization
SAN JUDAS PHARMACY CORP
Active
Other names
San Judas Pharmacy Corp
Organization subpart
No
Provider details
NPI number
Authorized official
PURO NARANJO (PRESIDENT/SECRETARY)
(305) 603-7145
Entity
Organization
Contact information
Practice address
2604 W 84TH ST, HIALEAH, FL 33016-5703
(305) 603-7145
(786) 518-3496
Mailing address
2604 W 84TH ST, HIALEAH, FL 33016-5703
(305) 603-7145
(786) 518-3496
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PH28699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147350
PK
—
Enumeration date
11/07/2014
Last updated
11/07/2014
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