Provider Demographics
NPI:1598121048
Name:FARM PULIDO
Entity Type:Organization
Organization Name:FARM PULIDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-225-1341
Mailing Address - Street 1:418 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-2918
Mailing Address - Country:US
Mailing Address - Phone:561-225-1341
Mailing Address - Fax:
Practice Address - Street 1:418 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2918
Practice Address - Country:US
Practice Address - Phone:561-225-1341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy