Organization
NOVA PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAHE MARRERO PHARMD (PRESIDENT)
(305) 262-6682
Entity
Organization
Contact information
Practice address
950 1ST ST S STE 103, WINTER HAVEN, FL 33880-3607
(305) 262-6682
(305) 264-4318
Mailing address
950 1ST ST S STE 103, WINTER HAVEN, FL 33880-3607
(305) 262-6682
(305) 264-4318
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5710226
NCPDP
FL
Enumeration date
04/17/2012
Last updated
09/29/2021
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