Provider Demographics
NPI:1700163136
Name:LITTLE FAMILY PHARMACY CORP
Entity Type:Organization
Organization Name:LITTLE FAMILY PHARMACY CORP
Other - Org Name:LITTLE FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-285-9333
Mailing Address - Street 1:2200 SW 16TH ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2067
Mailing Address - Country:US
Mailing Address - Phone:305-285-9333
Mailing Address - Fax:
Practice Address - Street 1:2200 SW 16TH ST
Practice Address - Street 2:STE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2067
Practice Address - Country:US
Practice Address - Phone:305-285-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH257493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5708219OtherNCPDP PROVIDER IDENTIFICATION NUMBER