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Organization

MED-SOURCE PHARMACY SERVICES CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DALLAS LONARDO (PRESIDENT)
(305) 854-7377
Entity
Organization

Contact information

Practice address
515 SW 17TH AVE STE 1, MIAMI, FL 33135-3878
(305) 854-7377
(305) 854-7327
Mailing address
515 SW 17TH AVE STE 1, MIAMI, FL 33135-3878
(305) 854-7377
(305) 854-7327

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH 23666
FL
3336L0003X
Long Term Care Pharmacy
PH23665
FL

Other

Enumeration date
02/04/2009
Last updated
10/23/2024
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