MEDICARE: MEMORIAL PILL BOX

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	PH11940	FL
2	333600000X	Pharmacy	PH11940	FL
3	3336C0003X	Community/Retail Pharmacy

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

General Provider Information

NPI Number	:	1780676510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL PILL BOX

Provider Business Mailing Address
First Line	:	122 W 146TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039-3802
Country	:	US
Telephone Number	:	888-685-9515
Fax Number	:	646-934-6409

Provider Business Practice Location Address
First Line	:	168 NW 26TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33127-4422
Country	:	US
Telephone Number	:	305-515-9000
Fax Number	:	954-368-6833

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	ERIC KINARIWALA
Credential	:
Telephone Number	:	888-685-9515

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	09/06/2022

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Directions to “MEMORIAL PILL BOX ” Practice Location

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