MEDICARE: U TRUST PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053087411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	U TRUST PHARMACY INC

Provider Business Mailing Address
First Line	:	6974 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33023-2676
Country	:	US
Telephone Number	:	954-589-0585
Fax Number	:

Provider Business Practice Location Address
First Line	:	6974 PEMBROKE RD
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33023-2676
Country	:	US
Telephone Number	:	954-589-0585
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. OSITA C EZENWA
Credential	:
Telephone Number	:	954-993-5066

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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Directions to “U TRUST PHARMACY INC ” Practice Location

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