Provider Demographics
NPI:1467959783
Name:NMB PHARMACY INC
Entity Type:Organization
Organization Name:NMB PHARMACY INC
Other - Org Name:NMB PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SIDDHARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:VISWANATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-768-9888
Mailing Address - Street 1:1203 NE 163RD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4634
Mailing Address - Country:US
Mailing Address - Phone:305-768-9888
Mailing Address - Fax:305-768-9828
Practice Address - Street 1:1203 NE 163RD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4634
Practice Address - Country:US
Practice Address - Phone:305-768-9888
Practice Address - Fax:631-382-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH313373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177083OtherPK