<Unavail>
LBN: 1492 Pharma Group Corp
<Unavail> is an health care organization with primary practice located at 6420 Sw 62Nd Ave , South Miami FL 33143-3302. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
1492 Pharma Group Corp can be contacted via phone (305) 665-4411, or through Martinez, Sonia Elena via phone (305) 665-4411.
Contact Information
Primary practice address
6420 Sw 62Nd Ave
South Miami FL 33143-3302
Phone: (305) 665-4411
Fax: (305) 663-3258
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PH22048 | Florida |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1417968058 |
|---|---|
| LBN Legal business name | 1492 Pharma Group Corp |
| DBA Doing business as | <Unavail> |
| Authorized official | Martinez, Sonia Elena BSPHARM |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Dec 12th, 2022 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417968058 | NPPES |
| Florida | MEDICAID | 007260700 | |
| Florida | MEDICAID | 019180600 |
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