Organization
ST JUDE PHARMACY & DISCOUNT INC
Active
Organization
ST JUDE PHARMACY & DISCOUNT INC
Active
Other names
ST JUDE PHARMACY & DISCOUNT, INC
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN HERNANDEZ (PRESIDENT)
(305) 621-3448
Entity
Organization
Contact information
Practice address
4822 NW 167TH ST, MIAMI LAKES, FL 33014-6426
(305) 621-3448
(305) 621-3464
Mailing address
4822 NW 167TH ST, MIAMI LAKES, FL 33014-6426
(305) 621-3448
(305) 621-3464
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25424
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133928
PK
—
Enumeration date
05/03/2011
Last updated
04/28/2017
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