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Organization

PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA

Active
Other names
Jackson South Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN NEMEROFF (ASSOCIATE DIRECTOR OF PHARMACY)
(305) 585-6780
Entity
Organization

Contact information

Practice address
9333 SW 152ND ST, PALMETTO BAY, FL 33157-1778
(305) 256-5182
(305) 256-5183
Mailing address
9333 SW 152ND ST, PALMETTO BAY, FL 33157-1778
(305) 256-5182
(305) 256-5183

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
3336C0003X
Community/Retail Pharmacy
3336M0002X
Mail Order Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003420600
FL
05
003420601
FL
01
2008200
PK
Enumeration date
12/12/2006
Last updated
02/28/2022
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