Organization
PAQMAR INC
Active
Other names
SHENANDOAH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROGELIO RODRIGUEZ (PRESIDENT)
(305) 858-2972
Entity
Organization
Contact information
Practice address
2200 SW 16TH ST 102 06, MIAMI, FL 33145-2021
(305) 858-2972
(305) 860-0560
Mailing address
2200 SW 16TH ST 102 06, MIAMI, FL 33145-2021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH17374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1059294
OTHER ID NUMBER
—
Enumeration date
09/06/2006
Last updated
07/26/2007
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