Provider Demographics
NPI:1053721738
Name:ENUKORA INC
Entity type:Organization
Organization Name:ENUKORA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANEGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BONIFACE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ENUKORA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:305-450-7709
Mailing Address - Street 1:18346 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4438
Mailing Address - Country:US
Mailing Address - Phone:305-651-4725
Mailing Address - Fax:
Practice Address - Street 1:18346 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4438
Practice Address - Country:US
Practice Address - Phone:305-651-4725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH280933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy