Organization
ILVA PHARMACY INC
Active
Organization
ILVA PHARMACY INC
Active
Other names
ILVA PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JANET DE LA CRUZ (PRESIDENT)
(305) 519-1577
Entity
Organization
Contact information
Practice address
10550 NW 77TH CT, STE 303, HIALEAH GARDENS, FL 33016-7084
(305) 821-8881
(305) 821-8851
Mailing address
10550 NW 77TH CT, STE 303, HIALEAH GARDENS, FL 33016-7084
(305) 821-8881
(305) 821-8851
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH23100
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032084
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/29/2007
Last updated
06/09/2010
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