Provider Demographics
NPI:1831321694
Name:MAGGIES PHARMACY INC
Entity Type:Organization
Organization Name:MAGGIES PHARMACY INC
Other - Org Name:MAGGIE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TWIGGI
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-960-7360
Mailing Address - Street 1:7590 NW 186TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2952
Mailing Address - Country:US
Mailing Address - Phone:305-818-0863
Mailing Address - Fax:305-818-0864
Practice Address - Street 1:7590 NW 186TH ST STE 109
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2952
Practice Address - Country:US
Practice Address - Phone:305-818-0863
Practice Address - Fax:305-818-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X
FLPH242073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2121533OtherPK