Organization
INDIAN STAR PHARM INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO REYES (PRESIDENT)
(786) 506-6084
Entity
Organization
Contact information
Practice address
9500 NW 79 AV BAY4, HIALEAH GARDENS, FL 33016
(786) 506-6084
Mailing address
9012 NW 145TH ST, HIALEAH, FL 33018
(305) 826-2170
(305) 826-2162
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25674
FL
Other
Enumeration date
06/22/2011
Last updated
12/27/2011
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