Provider Demographics
NPI:1285936179
Name:JENNIFER'S PHARMACY DISCOUNT CORP
Entity type:Organization
Organization Name:JENNIFER'S PHARMACY DISCOUNT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-401-7158
Mailing Address - Street 1:425 SW 22ND AVE
Mailing Address - Street 2:E-1
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3100
Mailing Address - Country:US
Mailing Address - Phone:786-401-7158
Mailing Address - Fax:786-401-6742
Practice Address - Street 1:425 SW 22ND AVE
Practice Address - Street 2:E-1
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3100
Practice Address - Country:US
Practice Address - Phone:786-401-7158
Practice Address - Fax:786-401-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-26
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6622990001Medicare NSC