Provider Demographics
NPI:1104247451
Name:BLUE RX PHARMACY
Entity type:Organization
Organization Name:BLUE RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CUELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-262-1770
Mailing Address - Street 1:251 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8009
Mailing Address - Country:US
Mailing Address - Phone:305-262-1770
Mailing Address - Fax:305-262-1771
Practice Address - Street 1:251 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8009
Practice Address - Country:US
Practice Address - Phone:305-262-1770
Practice Address - Fax:305-262-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH273273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy