MEDICARE: PODARIS GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336M0002X	Mail Order Pharmacy
2	3336S0011X	Specialty Pharmacy
3	3336H0001X	Home Infusion Therapy Pharmacy
4	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1629878491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODARIS GROUP LLC

Provider Business Mailing Address
First Line	:	711 PALM BLVD
Second Line	:
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2151
Country	:	US
Telephone Number	:	843-276-4195
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 NW 5TH WAY STE 1410B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	954-234-2693
Fax Number	:	954-708-1904

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN GARLAND NESBITT
Credential	:
Telephone Number	:	843-276-4195

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	02/10/2026

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