Organization
EL SHADAI PHCY DISCOUNT
Active
Other names
EL SHADAI MED EQUIP INC
Organization subpart
No
Provider details
NPI number
Authorized official
ALCIVIADES CISNEROS (OWNER)
(786) 344-0505
Entity
Organization
Contact information
Practice address
7911 NW 72ND AVE, STE 118B, MEDLEY, FL 33166-2227
(305) 863-3361
(305) 863-3550
Mailing address
7911 NW 72ND AVE, STE 118B, MEDLEY, FL 33166-2227
(305) 863-3361
(305) 863-3550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH22032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019707
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/14/2006
Last updated
01/14/2010
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