Provider Demographics
NPI:1275909327
Name:TAFT STREET PHARMACY
Entity Type:Organization
Organization Name:TAFT STREET PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CACERES PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-613-7997
Mailing Address - Street 1:7750 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5271
Mailing Address - Country:US
Mailing Address - Phone:954-613-7997
Mailing Address - Fax:954-613-7738
Practice Address - Street 1:7750 TAFT ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-5271
Practice Address - Country:US
Practice Address - Phone:954-613-7997
Practice Address - Fax:954-613-7738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC2626607038103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy