Provider Demographics
NPI:1538174131
Name:DIPARDI PHARMACY GROUP INC
Entity type:Organization
Organization Name:DIPARDI PHARMACY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIUCRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-947-6810
Mailing Address - Street 1:231 SUNNY ISLES BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:231 SUNNY ISLES BLVD
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4208
Practice Address - Country:US
Practice Address - Phone:305-947-6810
Practice Address - Fax:305-947-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH217163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1016939OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1016939OtherOTHER ID NUMBER