Organization
DESAM PHAMRACY GROUP LLC
Active
Other names
MAHAS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
YOLEXIS RODRIGUEZ (PRESIDENT)
(305) 551-8714
Entity
Organization
Contact information
Practice address
12486 SW 8TH ST, MIAMI, FL 33184-1400
(305) 551-8714
(305) 551-8715
Mailing address
12486 SW 8TH ST, MIAMI, FL 33184-1400
(305) 551-8714
(305) 551-8715
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23774
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049306
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/03/2009
Last updated
10/09/2009
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