Black & White Pharmacy Corp

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH25046 Issued in FL

Legal business name

BLACK & WHITE PHARMACY CORP

Practice address

1003 W Flagler St
Miami, FL 33130-1031

Phone

(305) 545-2108

Fax

(305) 545-2156

NPI assigned

Oct 5, 2012

Organization subpart

No

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

Authorized official

Name

Arsenio Fundora

Title

Owner

Phone

(786) 703-3968

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1780936476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331301031",
            "telephone_number": "305-545-2108",
            "fax_number": "305-545-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331301031",
            "telephone_number": "305-545-2108",
            "fax_number": "305-545-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK & WHITE PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "FUNDORA",
        "authorized_official_first_name": "ARSENIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-703-3968"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH25046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003611700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.