Organization
BLACK & WHITE PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRMAYUN HIDALGO HERNANDEZ (PRESIDENT)
(305) 545-2108
Entity
Organization
Contact information
Practice address
8381 BIRD RD, MIAMI, FL 33155-3353
(305) 545-2108
(305) 545-2156
Mailing address
8381 BIRD RD, MIAMI, FL 33155-3353
(305) 545-2108
(305) 545-2156
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
PH25045
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH25045
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003611700
—
FL
01
—
2127589
PK
—
Enumeration date
09/22/2010
Last updated
07/12/2021
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