San Judas Pharmacy Corp

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

PH28699 Issued in FL

Legal business name

SAN JUDAS PHARMACY CORP

Doing business as

San Judas Pharmacy Corp

Practice address

2604 W 84TH St
Hialeah, FL 33016-5703

Phone

(305) 603-7145

Fax

(786) 518-3496

NPI assigned

Nov 7, 2014

Last updated

Nov 7, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Puro Naranjo

Title

President/Secretary

Phone

(305) 603-7145

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• San Judas Pharmacy Corp Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1073919718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 W 84TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165703",
            "telephone_number": "305-603-7145",
            "fax_number": "786-518-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 W 84TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165703",
            "telephone_number": "305-603-7145",
            "fax_number": "786-518-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUDAS PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "NARANJO",
        "authorized_official_first_name": "PURO",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "305-603-7145"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "FL",
            "license": "PH28699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Judas Pharmacy Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialty Pharmacy in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Specialty Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.