Organization
MG UNIVERSAL PHARMACY INC
Active
Other names
MG UNIVERSAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRELIS LOPEZ (VP)
(305) 836-0071
Entity
Organization
Contact information
Practice address
4065 E 8TH AVE, HIALEAH, FL 33013-2856
(305) 836-0071
(305) 836-0072
Mailing address
4065 E 8TH AVE, HIALEAH, FL 33013-2856
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH21607
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015761
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
03/09/2009
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