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
About Stedi
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