Provider Demographics
NPI:1861873119
Name:PHARMACORP LAMEIRO INC
Entity type:Organization
Organization Name:PHARMACORP LAMEIRO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-703-4811
Mailing Address - Street 1:9155 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4652
Mailing Address - Country:US
Mailing Address - Phone:754-703-4811
Mailing Address - Fax:754-703-4812
Practice Address - Street 1:9155 TAFT ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-4652
Practice Address - Country:US
Practice Address - Phone:754-703-4811
Practice Address - Fax:754-703-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH292443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153344OtherPK