Provider Demographics
NPI:1457668493
Name:DAHLIA'S DRUGSTORE CORP
Entity Type:Organization
Organization Name:DAHLIA'S DRUGSTORE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-266-9929
Mailing Address - Street 1:251 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8009
Mailing Address - Country:US
Mailing Address - Phone:305-266-9929
Mailing Address - Fax:305-266-9930
Practice Address - Street 1:251 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8009
Practice Address - Country:US
Practice Address - Phone:305-266-9929
Practice Address - Fax:305-266-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy