MEDICARE: C D M & S, 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	183500000X	Pharmacist	PH1909	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	:	1639185101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C D M & S, INC

Provider Business Mailing Address
First Line	:	225 E PALMETTO PARK RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5013
Country	:	US
Telephone Number	:	561-395-1650
Fax Number	:	561-395-8529

Provider Business Practice Location Address
First Line	:	225 E PALMETTO PARK RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33432-5013
Country	:	US
Telephone Number	:	561-395-1650
Fax Number	:	561-395-8529

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	MR. DONALD SAKOLOVE
Credential	:	RPH
Telephone Number	:	561-395-1650

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	08/22/2020

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