Provider Demographics
NPI:1477850840
Name:HEALTH STAR PHARMACY DISCOUNT SUPPLY CORP
Entity Type:Organization
Organization Name:HEALTH STAR PHARMACY DISCOUNT SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FILGUEIRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-382-2259
Mailing Address - Street 1:11264 SW 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4203
Mailing Address - Country:US
Mailing Address - Phone:305-382-2255
Mailing Address - Fax:305-382-2259
Practice Address - Street 1:11264 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4203
Practice Address - Country:US
Practice Address - Phone:305-382-2255
Practice Address - Fax:305-382-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4571OtherDOC NUMBER