Provider Demographics
NPI:1508944786
Name:UNION PHARMACY AND MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:UNION PHARMACY AND MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CEPERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-262-4646
Mailing Address - Street 1:6456 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3009
Mailing Address - Country:US
Mailing Address - Phone:305-262-4646
Mailing Address - Fax:305-261-0190
Practice Address - Street 1:6456 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3009
Practice Address - Country:US
Practice Address - Phone:305-262-4646
Practice Address - Fax:305-261-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH185323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL025512200Medicaid
FL025512200Medicaid