Organization
PALMETTO BAY PHARMACY CORP
Active
Organization
PALMETTO BAY PHARMACY CORP
Active
Other names
PALMETTO BAY PHCY AND DISCOUNT
Organization subpart
No
Provider details
NPI number
Authorized official
EDEL CORRALES (PRESIDENT)
(786) 205-3422
Entity
Organization
Contact information
Practice address
17035 S DIXIE HWY, PALMETTO BAY, FL 33157-4362
(305) 969-2492
(305) 969-2497
Mailing address
17035 S DIXIE HWY, PALMETTO BAY, FL 33157-4362
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH22040
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020320
OTHER ID NUMBER
—
Enumeration date
07/11/2006
Last updated
11/07/2007
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