Provider Demographics
NPI:1407267313
Name:EMPORIUM PHARMACY
Entity Type:Organization
Organization Name:EMPORIUM PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-483-8500
Mailing Address - Street 1:2664 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1714
Mailing Address - Country:US
Mailing Address - Phone:786-483-8500
Mailing Address - Fax:786-483-8496
Practice Address - Street 1:2664 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1714
Practice Address - Country:US
Practice Address - Phone:786-483-8500
Practice Address - Fax:786-483-8496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH281243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy