Provider Demographics
NPI:1700265352
Name:US ALLIANCE PHARMACEUTICAL
Entity Type:Organization
Organization Name:US ALLIANCE PHARMACEUTICAL
Other - Org Name:RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:A
Authorized Official - Middle Name:
Authorized Official - Last Name:JABBARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-368-3226
Mailing Address - Street 1:1717 N BAYSHORE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1180
Mailing Address - Country:US
Mailing Address - Phone:786-777-0344
Mailing Address - Fax:786-777-0343
Practice Address - Street 1:1717 N BAYSHORE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1180
Practice Address - Country:US
Practice Address - Phone:786-777-0344
Practice Address - Fax:786-777-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH225453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032102800Medicaid