Organization
MEDI SHOW PHARMACY LLC
Active
Organization
MEDI SHOW PHARMACY LLC
Active
Other names
Medi Shop Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN DELGADO (MANAGER)
(407) 579-1045
Entity
Organization
Contact information
Practice address
715 N FERNCREEK AVE STE C, ORLANDO, FL 32803-4108
(407) 440-4504
(407) 674-7935
Mailing address
715 N FERNCREEK AVE STE C, ORLANDO, FL 32803-4108
(407) 440-4504
(407) 674-7935
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25893
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5710074
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/12/2012
Last updated
09/10/2012
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