Provider Demographics
NPI:1083049514
Name:INDEPENDENCE PHARMACYAND DISCOUNT INC
Entity Type:Organization
Organization Name:INDEPENDENCE PHARMACYAND DISCOUNT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-569-9000
Mailing Address - Street 1:5143 SW 8TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2442
Mailing Address - Country:US
Mailing Address - Phone:305-569-9000
Mailing Address - Fax:305-569-9100
Practice Address - Street 1:5143 SW 8TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2442
Practice Address - Country:US
Practice Address - Phone:305-569-9000
Practice Address - Fax:305-569-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy