Provider Demographics
NPI:1639317779
Name:SANTOS SUAREZ PHARMACY INC
Entity Type:Organization
Organization Name:SANTOS SUAREZ PHARMACY INC
Other - Org Name:SANTOS SUAREZ PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-2904
Mailing Address - Street 1:11300 NW 87TH CT
Mailing Address - Street 2:149
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4586
Mailing Address - Country:US
Mailing Address - Phone:305-821-2904
Mailing Address - Fax:305-821-2905
Practice Address - Street 1:11300 NW 87TH CT
Practice Address - Street 2:149
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4586
Practice Address - Country:US
Practice Address - Phone:305-821-2904
Practice Address - Fax:305-821-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH239513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1047009OtherNCPDP PROVIDER IDENTIFICATION NUMBER