Provider Demographics
NPI:1528115813
Name:UNION PHARMACY AND MEDICAL SUPPLIES II
Entity type:Organization
Organization Name:UNION PHARMACY AND MEDICAL SUPPLIES II
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-300-5887
Mailing Address - Street 1:2501 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2968
Mailing Address - Country:US
Mailing Address - Phone:305-661-8800
Mailing Address - Fax:305-663-1487
Practice Address - Street 1:2501 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2968
Practice Address - Country:US
Practice Address - Phone:305-661-8800
Practice Address - Fax:305-663-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336I0012X, 3336L0003X
FLPH224543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2008772OtherPK
FL003599200Medicaid
FL002659800Medicaid