Provider Demographics
NPI:1437243011
Name:FEMY DRUG CORP.
Entity Type:Organization
Organization Name:FEMY DRUG CORP.
Other - Org Name:OLYMPIA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ORESTES
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-221-4711
Mailing Address - Street 1:9884 SW 40 ST.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3912
Mailing Address - Country:US
Mailing Address - Phone:305-221-4711
Mailing Address - Fax:305-221-8058
Practice Address - Street 1:9884 SW 40 ST.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3912
Practice Address - Country:US
Practice Address - Phone:305-221-4711
Practice Address - Fax:305-221-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH213283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104566100Medicaid
FLPH21328OtherSTATE PHARMACY LICENSE #
FL1015937OtherNCPDP