Organization
WILLSON PHARMACY INC
Active
Other names
Willson Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS TALAVERA (OWNER)
(305) 644-2929
Entity
Organization
Contact information
Practice address
2183 SW 1ST ST, MIAMI, FL 33135-1636
(305) 644-2929
(305) 644-2329
Mailing address
2183 SW 1ST ST, MIAMI, FL 33135-1636
(305) 644-2929
(305) 644-2329
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24657
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1050640
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/19/2009
Last updated
10/19/2012
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