Provider Demographics
NPI:1578837324
Name:SOLUTIONS DRUG STORE LLC
Entity Type:Organization
Organization Name:SOLUTIONS DRUG STORE LLC
Other - Org Name:LA BOTICA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:DULCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-547-1004
Mailing Address - Street 1:774 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1206
Mailing Address - Country:US
Mailing Address - Phone:305-547-1004
Mailing Address - Fax:305-547-1006
Practice Address - Street 1:774 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1206
Practice Address - Country:US
Practice Address - Phone:305-547-1004
Practice Address - Fax:305-547-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-25
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH260313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5709677OtherNCPDP PROVIDER IDENTIFICATION NUMBER