Organization
KME RX INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JETENDRA ETWARU RPH (OWNER PHARMACIST)
(561) 432-0402
Entity
Organization
Contact information
Practice address
3491 S CONGRESS AVE, BAY 6, PALM SPRINGS, FL 33461-3021
(561) 432-0402
(561) 432-0403
Mailing address
3491 S CONGRESS AVE, BAY 6, PALM SPRINGS, FL 33461-3021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH20069
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026869100
—
FL
05
—
026869101
—
FL
01
—
1004023
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/26/2006
Last updated
03/07/2023
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