Organization
1 OLD RIVER PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRIZ CARREON (PRESIDENT)
(305) 477-6507
Entity
Organization
Contact information
Practice address
1879 NW 7TH ST, MIAMI, FL 33125-3503
(305) 477-6507
(305) 477-6518
Mailing address
1879 NW 7TH ST, MIAMI, FL 33125-3503
(305) 477-6507
(305) 477-6518
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2909746
FED ID
FL
Enumeration date
06/24/2010
Last updated
06/24/2010
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