Provider Demographics
NPI:1538281985
Name:CASTELLON INVESTMENTS INC
Entity Type:Organization
Organization Name:CASTELLON INVESTMENTS INC
Other - Org Name:GRAND PHARMACY DISCOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BADELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-635-7659
Mailing Address - Street 1:2140 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5432
Mailing Address - Country:US
Mailing Address - Phone:305-635-7659
Mailing Address - Fax:305-637-5613
Practice Address - Street 1:2140 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5432
Practice Address - Country:US
Practice Address - Phone:305-635-7659
Practice Address - Fax:305-637-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH24900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6429430001Medicare NSC