Provider Demographics
NPI:1821189192
Name:CABANA PHARMACY , INC
Entity Type:Organization
Organization Name:CABANA PHARMACY , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-573-8172
Mailing Address - Street 1:5201 PINE TREE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2109
Mailing Address - Country:US
Mailing Address - Phone:305-229-9685
Mailing Address - Fax:305-573-9575
Practice Address - Street 1:119 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3951
Practice Address - Country:US
Practice Address - Phone:305-573-8172
Practice Address - Fax:305-573-9575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy