Provider Demographics
NPI:1922422153
Name:MEDICAL PRIORITY PHARMACY, LLC.
Entity Type:Organization
Organization Name:MEDICAL PRIORITY PHARMACY, LLC.
Other - Org Name:MARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-823-0915
Mailing Address - Street 1:5350 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2746
Mailing Address - Country:US
Mailing Address - Phone:305-823-0915
Mailing Address - Fax:305-823-4055
Practice Address - Street 1:5350 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2746
Practice Address - Country:US
Practice Address - Phone:305-823-0915
Practice Address - Fax:305-823-4055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH291113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy