Provider Demographics
NPI:1336335892
Name:DADE PHARMACY INC
Entity Type:Organization
Organization Name:DADE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-805-0035
Mailing Address - Street 1:261 WESTWARD DR
Mailing Address - Street 2:115-116
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5290
Mailing Address - Country:US
Mailing Address - Phone:305-805-0035
Mailing Address - Fax:305-805-0036
Practice Address - Street 1:261 WESTWARD DR
Practice Address - Street 2:115-116
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5290
Practice Address - Country:US
Practice Address - Phone:305-805-0035
Practice Address - Fax:305-805-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN