Provider Demographics
NPI:1972975829
Name:GRAND PHARMACY - DISCOUNT, INC.
Entity Type:Organization
Organization Name:GRAND PHARMACY - DISCOUNT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:786-615-3586
Mailing Address - Street 1:12486 SW 8 ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184
Mailing Address - Country:US
Mailing Address - Phone:786-615-3586
Mailing Address - Fax:786-615-3679
Practice Address - Street 1:12486 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1400
Practice Address - Country:US
Practice Address - Phone:786-615-3586
Practice Address - Fax:786-615-3679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH293083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy