MEDICARE: BEDB PHARMACIES 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	3336C0003X	Community/Retail Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy	PH25072	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5703031	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1376846436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEDB PHARMACIES LLC

Provider Business Mailing Address
First Line	:	2629 WEST OAKLAND
Second Line	:	PARK BLVD
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311
Country	:	US
Telephone Number	:	954-485-1099
Fax Number	:	954-832-9143

Provider Business Practice Location Address
First Line	:	2629 W OAKLAND PARK BLVD
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1355
Country	:	US
Telephone Number	:	954-485-1099
Fax Number	:	954-832-9143

Authorized Official
Title or Position	:	RX MGR
Name	:	STU WHITEMAN
Credential	:
Telephone Number	:	954-485-1099

Provider Enumeration Date	:	12/13/2010
Last Update Date	:	12/13/2010

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Directions to “BEDB PHARMACIES LLC ” Practice Location

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