Organization
BETTY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHICHO LOPEZ (PRESIDENT)
(786) 222-1234
Entity
Organization
Contact information
Practice address
2500 NW 79TH AVE, SUITE 241, DORAL, FL 33122-1073
(786) 222-1234
(786) 222-1235
Mailing address
2500 NW 80 AVE, SUITE 241, MIAMI, FL 33122
(786) 222-1234
(786) 222-1235
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3456
DOC NUMBER
FL
Enumeration date
05/11/2011
Last updated
05/11/2011
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