Organization
MGC PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS ALFONSO-SERRANO PHARMD MSC (PHARMACY OWNER/ MANAGER ON RECORD)
(305) 586-6443
Entity
Organization
Contact information
Practice address
1516 E 4TH AVE, HIALEAH, FL 33010-3159
(305) 586-6443
(305) 884-7454
Mailing address
1516 E 4TH AVE, HIALEAH, FL 33010-3159
(305) 586-6443
(305) 884-7454
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH22923
PHARMACY
FL
Enumeration date
07/30/2007
Last updated
11/10/2010
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