Provider Demographics
NPI:1437444379
Name:SHUTTLE PHARMACY DISCOUNT INC
Entity Type:Organization
Organization Name:SHUTTLE PHARMACY DISCOUNT INC
Other - Org Name:SHUTTLE PHARMACY DISCOUNT INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-493-3542
Mailing Address - Street 1:243 N FLAGLER AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6130
Mailing Address - Country:US
Mailing Address - Phone:305-506-8462
Mailing Address - Fax:305-506-8462
Practice Address - Street 1:243 N FLAGLER AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6130
Practice Address - Country:US
Practice Address - Phone:305-506-8462
Practice Address - Fax:305-506-8462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH260853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130762OtherPK