Provider Demographics
NPI:1396188769
Name:ANDYS PHARMACY AND DISCOUNT
Entity Type:Organization
Organization Name:ANDYS PHARMACY AND DISCOUNT
Other - Org Name:ANDY'S PHARMACY AND DISCOUNT INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-443-3507
Mailing Address - Street 1:4315 NW 7TH ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3587
Mailing Address - Country:US
Mailing Address - Phone:305-443-3507
Mailing Address - Fax:305-443-3510
Practice Address - Street 1:4315 NW 7TH ST STE 15
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3560
Practice Address - Country:US
Practice Address - Phone:305-443-3507
Practice Address - Fax:305-443-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH299463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141025OtherPK