MEDICARE: RODZ PRESCRIPTION CENTER 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	3336C0003X	Community/Retail Pharmacy	PH25924	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5709300	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1093089666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODZ PRESCRIPTION CENTER INC

Provider Business Mailing Address
First Line	:	1647 SUN CITY CENTER PLZ
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-5373
Country	:	US
Telephone Number	:	813-633-5577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1647 SUN CITY CENTER PLZ
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-5373
Country	:	US
Telephone Number	:	813-633-5577
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	ERNEST RODRIGUEZ
Credential	:
Telephone Number	:	813-600-8556

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	03/05/2012

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Directions to “RODZ PRESCRIPTION CENTER INC ” Practice Location

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