Organization
MAGNA EMPIRE GROUP INC
Active
Other names
CORAL WEST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NOHARI MARTINEZ BA (PRES)
(305) 227-1174
Entity
Organization
Contact information
Practice address
2406 SW 137TH AVE, 2406 SW 137TH AVE, MIAMI, FL 33175-6311
(305) 227-1174
(305) 227-1171
Mailing address
2406 SW 137TH AVE, 2406 SW 137TH AVE, MIAMI, FL 33175-6311
(305) 227-1174
(305) 227-1171
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23405
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000230200
—
FL
01
—
1036260
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/11/2008
Last updated
07/18/2012
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