Provider Demographics
NPI:1003105859
Name:NARANJA DISCOUNT PHARMACY LLC
Entity Type:Organization
Organization Name:NARANJA DISCOUNT PHARMACY LLC
Other - Org Name:NARANJA DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIDEON
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-257-0081
Mailing Address - Street 1:26799 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7403
Mailing Address - Country:US
Mailing Address - Phone:305-257-0081
Mailing Address - Fax:305-257-0094
Practice Address - Street 1:26799 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-7403
Practice Address - Country:US
Practice Address - Phone:305-257-0081
Practice Address - Fax:305-257-0094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH253663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5705213OtherNCPDP PROVIDER IDENTIFICATION NUMBER