Organization
BLUE STAR PHARMACY INC
Active
Other names
BLUE STAR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE HERNANDEZ (PRESIDENT)
(305) 222-1818
Entity
Organization
Contact information
Practice address
3009 SW 107TH AVE, MIAMI, FL 33165-2434
(305) 222-1818
(305) 222-1819
Mailing address
3009 SW 107TH AVE, MIAMI, FL 33165-2434
(305) 222-1818
(305) 222-1819
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24830
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003954400
—
FL
01
—
2126323
PK
—
Enumeration date
08/19/2010
Last updated
03/31/2015
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