Provider Demographics
NPI:1659551422
Name:SAN MARTIN'S PHARMACY INC.
Entity Type:Organization
Organization Name:SAN MARTIN'S PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:GISELA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,PHARMD
Authorized Official - Phone:305-445-0033
Mailing Address - Street 1:2255 SW 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3177
Mailing Address - Country:US
Mailing Address - Phone:305-445-0033
Mailing Address - Fax:305-445-8811
Practice Address - Street 1:2255 SW 32ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3177
Practice Address - Country:US
Practice Address - Phone:305-445-0033
Practice Address - Fax:305-445-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215014949OtherNPI-PHARMACY
FL1074183OtherNABP
FL0979270001Medicare NSC