El Shadai Phcy Discount

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH22032 Issued in FL

Legal business name

EL SHADAI PHCY DISCOUNT

Doing business as

El Shadai Med Equip Inc

Practice address

7911 NW 72ND Ave
Ste 118B
Medley, FL 33166-2227

Phone

(305) 863-3361

Fax

(305) 863-3550

NPI assigned

Jun 14, 2006

Last updated

Jan 14, 2010By 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

Alciviades Cisneros

Title

Owner

Phone

(786) 344-0505

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EL SHADAI MED EQUIP INC Doing business as

Locations

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1285677500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7911 NW 72ND AVE",
            "address_2": "STE 118B",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331662227",
            "telephone_number": "305-863-3361",
            "fax_number": "305-863-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7911 NW 72ND AVE",
            "address_2": "STE 118B",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331662227",
            "telephone_number": "305-863-3361",
            "fax_number": "305-863-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL SHADAI PHCY DISCOUNT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "ALCIVIADES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-344-0505"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH22032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1019707",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EL SHADAI MED EQUIP INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Medley, FL
• Providers in Medley, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.