Organization
PHARMACY AT 100 NW 170TH ST, LLC
Active
Other names
DPR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD RAY (OWNER)
(917) 440-1529
Entity
Organization
Contact information
Practice address
15485 EAGLE NEST LN STE 230, MIAMI LAKES, FL 33014-2222
(917) 440-1529
Mailing address
15485 EAGLE NEST LN STE 230, MIAMI LAKES, FL 33014-2222
(917) 440-1529
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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