Organization
HUMANA MEDICAL PLAN INC
Active
Other names
HUMANA PHARMACY 47905
Organization subpart
No
Provider details
NPI number
Authorized official
NILSA AVERHOFF (MANAGER)
(305) 270-2766
Entity
Organization
Contact information
Practice address
11701 MILLS DR, MIAMI, FL 33183-4836
(305) 270-2766
(305) 596-3132
Mailing address
11701 MILLS DR, MIAMI, FL 33183-4836
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PH11268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072064
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
08/22/2020
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