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NPI Code Detail

MEDICARE: SIGNATURE PHARMACY INC

MEDICARE: SIGNATURE 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
1333600000XPharmacy
23336M0002XMail Order Pharmacy
33336C0004XCompounding Pharmacy
43336C0003XCommunity/Retail PharmacyPH18485FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11095149OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821019878
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIGNATURE PHARMACY INC
Provider Business Mailing Address
First Line : 2304 ALOMA AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-3330
Country : US
Telephone Number : 407-673-2222
Fax Number : 407-673-1234
Provider Business Practice Location Address
First Line : 2304 ALOMA AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-3330
Country : US
Telephone Number : 407-673-2222
Fax Number : 407-673-1234
Authorized Official
Title or Position : PRES
Name : NAOMI LOOMIS
Credential : RPH
Telephone Number : 407-447-9844
Provider Enumeration Date : 07/22/2006
Last Update Date : 07/01/2010

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Directions to “SIGNATURE PHARMACY INC ” Practice Location

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