Provider Demographics
NPI:1598000291
Name:ANDY'S PHARMACY & DISCOUNT, INC
Entity Type:Organization
Organization Name:ANDY'S PHARMACY & DISCOUNT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-523-8114
Mailing Address - Street 1:4315 NW 7TH ST
Mailing Address - Street 2:STE 15
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3560
Mailing Address - Country:US
Mailing Address - Phone:786-523-8114
Mailing Address - Fax:
Practice Address - Street 1:4315 NW 7TH ST
Practice Address - Street 2:STE 15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3560
Practice Address - Country:US
Practice Address - Phone:786-523-8114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 263853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy