Provider Demographics
NPI:1457366072
Name:O2M NEBMED INC
Entity Type:Organization
Organization Name:O2M NEBMED INC
Other - Org Name:GARCIA PHARMACY DISCOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-588-2252
Mailing Address - Street 1:2525 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-6250
Mailing Address - Country:US
Mailing Address - Phone:561-588-2252
Mailing Address - Fax:561-586-4588
Practice Address - Street 1:2525 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-6250
Practice Address - Country:US
Practice Address - Phone:561-588-2252
Practice Address - Fax:561-586-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
FLPH196503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026488100Medicaid
2006512OtherPK