Organization
MARANATHA PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ALVAREZ (PRESIDENT)
(305) 642-7770
Entity
Organization
Contact information
Practice address
138 BEACOM BLVD, MIAMI, FL 33135-1534
(305) 642-7770
(305) 642-7771
Mailing address
138 BEACOM BLVD, MIAMI, FL 33135-1534
(305) 642-7770
(305) 642-7771
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3853
DOC NUMB
FL
Enumeration date
04/02/2012
Last updated
04/02/2012
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