Organization
MY PHARMACY OF BIRD ROAD INC
Active
Other names
ALLEN'S MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
AURELIO COLLAZO BS PHARMACY (PRESIDENT)
(305) 666-8582
Entity
Organization
Contact information
Practice address
4000 SW 57TH AVE, MIAMI, FL 33155-5318
(305) 666-8582
(305) 666-9110
Mailing address
4000 SW 57TH AVE, MIAMI, FL 33155-5318
(305) 666-8582
(305) 666-9110
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PH28703
FL
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109383500
—
FL
01
—
2005251
PK
—
Enumeration date
07/07/2005
Last updated
01/12/2015
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