Provider Demographics
NPI:1558322008
Name:NEGLEX INC
Entity Type:Organization
Organization Name:NEGLEX INC
Other - Org Name:LATINA PHARMACY & DISCOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:NEGRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-551-4166
Mailing Address - Street 1:300 SW 107TH AVE
Mailing Address - Street 2:STE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3601
Mailing Address - Country:US
Mailing Address - Phone:305-551-4177
Mailing Address - Fax:305-551-5881
Practice Address - Street 1:300 SW 107TH AVE
Practice Address - Street 2:STE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3601
Practice Address - Country:US
Practice Address - Phone:305-551-4177
Practice Address - Fax:305-551-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH20815333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026974300Medicaid
FL026974300Medicaid