MEDICARE: POLYPILL COMPOUND MEDICATIONS LLC

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	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy	PH25791	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5709398	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1164709663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLYPILL COMPOUND MEDICATIONS LLC

Provider Business Mailing Address
First Line	:	5701 SW 134TH AVE
Second Line	:
City	:	SOUTHWEST RANCHES
State	:	FL
Zip	:	33330-3100
Country	:	US
Telephone Number	:	407-920-1155
Fax Number	:	407-540-9614

Provider Business Practice Location Address
First Line	:	4401 SHERIDAN ST STE B
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	855-765-9745
Fax Number	:	866-355-0176

Authorized Official
Title or Position	:	VP BUSINESS DEVELOPMENT
Name	:	CHARLES JACKSON
Credential	:
Telephone Number	:	407-920-1155

Provider Enumeration Date	:	11/11/2011
Last Update Date	:	11/01/2012

Similar Medicare Providers

1710986203 — LATO DRUG COMPANY INC
Practice Location Address:

4401 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 954-989-6524
Practice Fax: 954-985-8239

1558482893 — KATHERINE VENTURA LMT
Practice Location Address:

4401 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 954-893-7233
Practice Fax:

1114179686 — MS. VERONIQUE FARNAULT L.M.T.
Practice Location Address:

4407 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 786-355-0692
Practice Fax:

1669770236 — HOLLYWOOD ACCIDENT & INJURY CENTER LLC
Practice Location Address:

4401 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 954-589-0730
Practice Fax: 954-589-0733

1558653337 — DR. ANUJ MALIK
Practice Location Address:

4461 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 954-966-6352
Practice Fax:

1023388915 — THE WELLNESS CENTER AT POST HASTE
Practice Location Address:

4401 SHERIDAN ST
HOLLYWOOD, FL
33021-3513

Practice Phone: 954-239-7179
Practice Fax: 954-874-6237

Directions to “POLYPILL COMPOUND MEDICATIONS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.