Provider Demographics
NPI:1306027560
Name:KENDALL RX INC
Entity Type:Organization
Organization Name:KENDALL RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SUZARTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-275-9149
Mailing Address - Street 1:9783 SW 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4615
Mailing Address - Country:US
Mailing Address - Phone:305-275-9149
Mailing Address - Fax:305-275-9148
Practice Address - Street 1:9783 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4615
Practice Address - Country:US
Practice Address - Phone:305-275-9149
Practice Address - Fax:305-275-9148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH230463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH23046OtherPHARMACY LICENSE
FL6047530001Medicare NSC