Provider Demographics
NPI:1770221921
Name:LA FAMILIA PHARMACY CORP
Entity Type:Organization
Organization Name:LA FAMILIA PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSTAMANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-409-4791
Mailing Address - Street 1:454 NW 22ND AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3355
Mailing Address - Country:US
Mailing Address - Phone:786-409-4791
Mailing Address - Fax:786-452-0150
Practice Address - Street 1:454 NW 22ND AVE STE 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3355
Practice Address - Country:US
Practice Address - Phone:786-409-4791
Practice Address - Fax:786-452-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16272OtherNUMB