Provider Demographics
NPI:1952720963
Name:ZUMA PHARMACY INC
Entity Type:Organization
Organization Name:ZUMA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA RUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-502-8290
Mailing Address - Street 1:554 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5349
Mailing Address - Country:US
Mailing Address - Phone:786-502-8290
Mailing Address - Fax:786-502-8136
Practice Address - Street 1:554 HIALEAH DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5349
Practice Address - Country:US
Practice Address - Phone:786-502-8290
Practice Address - Fax:786-502-8136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy