Organization
BLACK & WHITE PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARSENIO FUNDORA (OWNER)
(786) 703-3968
Entity
Organization
Contact information
Practice address
1003 W FLAGLER ST, MIAMI, FL 33130-1031
(305) 545-2108
(305) 545-2156
Mailing address
1003 W FLAGLER ST, MIAMI, FL 33130-1031
(305) 545-2108
(305) 545-2156
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH25046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003611700
—
FL
Enumeration date
10/05/2012
Last updated
10/26/2017
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