MEDICARE: MAXXYCOM INVESTMENT CORP

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
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH24351	FL

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	:	1366770976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXXYCOM INVESTMENT CORP

Provider Business Mailing Address
First Line	:	1825 COLLIER PKWY
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-8718
Country	:	US
Telephone Number	:	813-406-4929
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 COLLIER PKWY
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-8718
Country	:	US
Telephone Number	:	813-406-4929
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PARVINDER S KAINTH
Credential	:
Telephone Number	:	727-271-1984

Provider Enumeration Date	:	11/20/2009
Last Update Date	:	02/24/2020

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Directions to “MAXXYCOM INVESTMENT CORP ” Practice Location

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