Organization
ALDER PHARMACY LLC
Active
Other names
ALDER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OLAF ESTEVEZ-GONZALEZ (PHARMACIST/PDM)
(305) 999-1469
Entity
Organization
Contact information
Practice address
729 NE 79TH ST, MIAMI, FL 33138-4711
(305) 999-1469
(305) 999-1527
Mailing address
729 NE 79TH ST, MIAMI, FL 33138-4711
(305) 999-1469
(305) 999-1527
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25356
FL
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003701600
—
FL
01
—
2129596
PK
—
Enumeration date
03/18/2011
Last updated
03/09/2015
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