Organization
QUALITY PHARMACY DISCOUNT CORP
Active
Other names
Quality Pharmacy & Discount Corp
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO FUNDORA (PHARMACY TECH / PRESIDENT)
(305) 200-3853
Entity
Organization
Contact information
Practice address
1133 W 29TH ST, HIALEAH, FL 33012-5063
(305) 200-3853
(786) 953-6131
Mailing address
1133 W 29TH ST, HIALEAH, FL 33012-5063
(305) 200-3853
(786) 953-6131
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24565
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057276
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/08/2010
Last updated
01/24/2012
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