Organization Active NPI

Country Club Pharmacy and Discount Inc

  • Community/Retail Pharmacy
  • Hialeah, FL
National Provider Identifier
1356641559
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
COUNTRY CLUB PHARMACY AND DISCOUNT INC
Practice address
5911 NW 173Rd Dr
# 6
Hialeah, FL 33015-5121
Phone
(305) 828-8600
Fax
(305) 828-8630
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Daisy Martinez
Title
President
Phone
(305) 828-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X FL Primary

Addresses

Primary practice location

5911 NW 173Rd Dr
# 6
Hialeah, FL 33015-5121

Mailing address

5911 NW 173Rd Dr
# 6
Hialeah, FL 33015-5121
Phone (305) 828-8600

Other identifiers 1

IdentifierTypeStateIssuer
37199OtherFLDOCUMENT NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Country Club Pharmacy and Discount Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1356641559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 NW 173RD DR",
            "address_2": "# 6",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155121",
            "telephone_number": "305-828-8600",
            "fax_number": "305-828-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 NW 173RD DR",
            "address_2": "# 6",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155121",
            "telephone_number": "305-828-8600",
            "fax_number": "305-828-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CLUB PHARMACY AND DISCOUNT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "DAISY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-828-8600"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCUMENT NUMBER",
            "identifier": "37199",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.