Provider Demographics
NPI:1285647859
Name:JRM PHARMACY INC
Entity Type:Organization
Organization Name:JRM PHARMACY INC
Other - Org Name:SUPER DRUGS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARQUIMIDES
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-448-5958
Mailing Address - Street 1:5512 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2220
Mailing Address - Country:US
Mailing Address - Phone:305-448-5958
Mailing Address - Fax:305-445-1067
Practice Address - Street 1:5512 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2220
Practice Address - Country:US
Practice Address - Phone:305-448-5958
Practice Address - Fax:305-445-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 124953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1091060001Medicare ID - Type Unspecified