Provider Demographics
NPI:1568638955
Name:PHARMAG INC
Entity Type:Organization
Organization Name:PHARMAG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYDEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:305-382-3000
Mailing Address - Street 1:9724 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7513
Mailing Address - Country:US
Mailing Address - Phone:305-382-3000
Mailing Address - Fax:305-382-3003
Practice Address - Street 1:9724 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7513
Practice Address - Country:US
Practice Address - Phone:305-382-3000
Practice Address - Fax:305-382-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH246603336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1034901OtherNCPDP PROVIDER IDENTIFICATION NUMBER