Provider Demographics
NPI:1831513613
Name:MAZ PHARMACY DISCOUNT CORP
Entity type:Organization
Organization Name:MAZ PHARMACY DISCOUNT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-703-3263
Mailing Address - Street 1:3825 W 16TH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7005
Mailing Address - Country:US
Mailing Address - Phone:786-703-3263
Mailing Address - Fax:786-703-3267
Practice Address - Street 1:3825 W 16TH AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7005
Practice Address - Country:US
Practice Address - Phone:786-703-3263
Practice Address - Fax:786-703-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH274793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy