Organization
MORTAR & PESTLE PHARMACY INC
Active
Other names
MORTAR & PESTLE the Boutique PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDES SILVA BS PHARM RPH (PIC)
(305) 775-9021
Entity
Organization
Contact information
Practice address
12920 SW 119TH ST, MIAMI, FL 33186-4506
(305) 603-9958
(305) 603-9958
Mailing address
12920 SW 119TH ST, MIAMI, FL 33186-4506
(305) 603-9958
(305) 603-9958
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH22625
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031999600
—
FL
01
—
1022728
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2006
Last updated
08/08/2012
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