Provider Demographics
NPI:1497810691
Name:LA CARIDAD PHARMACY INC
Entity Type:Organization
Organization Name:LA CARIDAD PHARMACY INC
Other - Org Name:LA CARIDAD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-207-9395
Mailing Address - Street 1:4041 SW 96TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5104
Mailing Address - Country:US
Mailing Address - Phone:305-220-8822
Mailing Address - Fax:305-220-8866
Practice Address - Street 1:4041 SW 96TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5104
Practice Address - Country:US
Practice Address - Phone:305-220-8822
Practice Address - Fax:305-220-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH214073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005162OtherPK
5530810001Medicare NSC