Provider Demographics
NPI:1215336607
Name:UMBRELLA PHARMACY DISCOUNT CORP
Entity type:Organization
Organization Name:UMBRELLA PHARMACY DISCOUNT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:INES
Authorized Official - Last Name:CERVANTES,
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-984-7612
Mailing Address - Street 1:10521 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3747
Mailing Address - Country:US
Mailing Address - Phone:786-332-2477
Mailing Address - Fax:786-332-2521
Practice Address - Street 1:10521 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3747
Practice Address - Country:US
Practice Address - Phone:786-332-2477
Practice Address - Fax:786-332-2521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH284003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy