Organization
LUPER CORP
Active
Other names
40TH STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LOURDES DEL CARMEN PEREZ (TREASURER)
(305) 554-0438
Entity
Organization
Contact information
Practice address
9258 SW 40TH ST, MIAMI, FL 33165-4151
(305) 554-0438
(305) 553-2197
Mailing address
9258 SW 40TH ST, MIAMI, FL 33165-4151
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH0012004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023351600
—
FL
01
—
1047629
OTHER ID NUMBER
—
Enumeration date
02/24/2007
Last updated
07/28/2023
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