Organization
MGC PHARMACY LLC
Active
Other names
MGC Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS ALFONSO (CLINICAL PHARMACY DIRECTOR)
(305) 884-7455
Entity
Organization
Contact information
Practice address
1516 E 4TH AVE, HIALEAH, FL 33010-3159
(305) 884-7455
(305) 884-7454
Mailing address
1516 E 4TH AVE, HIALEAH, FL 33010-3159
(305) 884-7455
(305) 884-7454
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH25619
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5707370
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/09/2011
Last updated
09/09/2011
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