Provider Demographics
NPI:1578994257
Name:SKY PHARMACY AND DISCOUNT CORP
Entity Type:Organization
Organization Name:SKY PHARMACY AND DISCOUNT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALIET
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-397-9887
Mailing Address - Street 1:2414 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2064
Mailing Address - Country:US
Mailing Address - Phone:954-929-6500
Mailing Address - Fax:954-929-6655
Practice Address - Street 1:2414 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2064
Practice Address - Country:US
Practice Address - Phone:954-929-6500
Practice Address - Fax:954-929-6655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH272623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016845600Medicaid