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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