Doctor Diabetic Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24828 Issued in FL

Legal business name

DOCTOR DIABETIC PHARMACY INC

Doing business as

Doctor Diabetic Pharmacy, Inc

Practice address

100 NE 28TH St
Miami, FL 33137-4423

Phone

(888) 829-7581

Fax

(866) 989-5899

NPI assigned

Aug 23, 2010

Last updated

Sep 3, 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

Clayton Edwards

Title

Sr. VP Pharmacy Operation

Phone

(888) 829-7581

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DOCTOR DIABETIC PHARMACY, INC Doing business as

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1659687119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE 28TH STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "888-829-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE 28TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331374423",
            "telephone_number": "888-829-7581",
            "fax_number": "866-989-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR DIABETIC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "SR. VP PHARMACY OPERATION",
        "authorized_official_telephone_number": "888-829-7581"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5701417",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOCTOR DIABETIC PHARMACY, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.