Provider Demographics
NPI:1598115958
Name:CITY DISCOUNT PHARMACY
Entity Type:Organization
Organization Name:CITY DISCOUNT PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIRMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-514-4694
Mailing Address - Street 1:2330 N WICKHAM RD STE 7
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8183
Mailing Address - Country:US
Mailing Address - Phone:321-425-4377
Mailing Address - Fax:
Practice Address - Street 1:2330 N WICKHAM RD STE 7
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8183
Practice Address - Country:US
Practice Address - Phone:321-425-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH302143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy