Provider Demographics
NPI:1396846473
Name:LAS AMERICAS PARMACY CORP.
Entity Type:Organization
Organization Name:LAS AMERICAS PARMACY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GEGUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-828-3388
Mailing Address - Street 1:4544 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3325
Mailing Address - Country:US
Mailing Address - Phone:305-828-3388
Mailing Address - Fax:305-828-3377
Practice Address - Street 1:4544 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3325
Practice Address - Country:US
Practice Address - Phone:305-828-3388
Practice Address - Fax:305-828-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH196213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1001635OtherNCPDP
FL4957830001Medicare ID - Type Unspecified