Organization
BRANCH ENTERPRISES
Active
Other names
CMS RX
Organization subpart
No
Provider details
NPI number
Authorized official
EVANS BRANCH III PHARMD (PRESIDENT)
(305) 969-3353
Entity
Organization
Contact information
Practice address
17490 SW 104TH AVE, STE B, MIAMI, FL 33157-4200
(305) 969-3353
(305) 969-3115
Mailing address
17490 SW 104TH AVE, STE B, MIAMI, FL 33157-4200
(305) 969-3353
(305) 969-3115
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH18244
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253316000
—
FL
01
—
1094692
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/19/2006
Last updated
02/28/2008
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