Provider Demographics
NPI:1356520910
Name:NAVARRO DISCOUNT PHARMACIES NO. 23
Entity type:Organization
Organization Name:NAVARRO DISCOUNT PHARMACIES NO. 23
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RX MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-636-7779
Mailing Address - Street 1:9400 NW 104TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1333
Mailing Address - Country:US
Mailing Address - Phone:305-636-7779
Mailing Address - Fax:305-636-6236
Practice Address - Street 1:1700 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4437
Practice Address - Country:US
Practice Address - Phone:305-636-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL032298901332B00000X
FL032298900333600000X
FL6098980001333600000X
FL1030181333600000X
FLPH0023063333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032298900Medicaid
FL032298901Medicaid
FL1030181OtherNCPDP
FL1030181OtherNCPDP