Provider Demographics
NPI:1063082451
Name:ROCKET RX PHARMACY CORP
Entity type:Organization
Organization Name:ROCKET RX PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES
Authorized Official - Prefix:
Authorized Official - First Name:MIRELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-469-1008
Mailing Address - Street 1:729 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4553
Mailing Address - Country:US
Mailing Address - Phone:786-773-5845
Mailing Address - Fax:786-773-5708
Practice Address - Street 1:729 E 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4553
Practice Address - Country:US
Practice Address - Phone:786-773-5845
Practice Address - Fax:786-773-5708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0610OtherNUMB