Pharmacy at 100 NW 170TH St, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

PHARMACY AT 100 NW 170TH ST, LLC

Doing business as

DPR Pharmacy

Practice address

15485 Eagle Nest LN Ste 230
Miami Lakes, FL 33014-2222

Phone

(917) 440-1529

NPI assigned

Apr 4, 2024

Last updated

Apr 4, 2024By 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

Richard Ray

Title

Owner

Phone

(917) 440-1529

Specialties & licenses 2

Addresses

Other names 1

• DPR PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1215789946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN STE 230",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142222",
            "telephone_number": "917-440-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN STE 230",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142222",
            "telephone_number": "917-440-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY AT 100 NW 170TH ST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-440-1529"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DPR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Compounding Pharmacy in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.