MEDICARE: AEROCARE 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336M0002X	Mail Order Pharmacy	20910	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588604078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AEROCARE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	2233 E MAIN ST
Second Line	:
City	:	MONTROSE
State	:	CO
Zip	:	81401-3831
Country	:	US
Telephone Number	:	970-249-3700
Fax Number	:	970-497-8415

Provider Business Practice Location Address
First Line	:	15401 VANTAGE PKWY W
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77032-1968
Country	:	US
Telephone Number	:	281-590-8933
Fax Number	:	281-590-8552

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEPHEN P GRIGGS
Credential	:
Telephone Number	:	407-206-0040

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	03/25/2010

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Directions to “AEROCARE PHARMACY, INC. ” Practice Location

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