Organization
SOUTHWEST RETAIL PHARMACY
Active
Organization
SOUTHWEST RETAIL PHARMACY
Active
Other names
Southwest Retail Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL CANCIO (PRESIDENT)
(305) 224-5958
Entity
Organization
Contact information
Practice address
27391 S DIXIE HWY, NARANJA, FL 33032-8210
(305) 224-5958
(786) 581-5429
Mailing address
27391 S DIXIE HWY, NARANJA, FL 33032-8210
(305) 224-5958
(786) 581-5429
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28327
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150428
PK
—
Enumeration date
03/05/2015
Last updated
03/05/2015
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