MEDICARE: EAGLE PHARMACY LLC

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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1891321089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE PHARMACY LLC

Provider Business Mailing Address
First Line	:	330 EAGLES LANDING DR STE 172
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3041
Country	:	US
Telephone Number	:	888-920-0527
Fax Number	:	877-816-5523

Provider Business Practice Location Address
First Line	:	330 EAGLES LANDING DR STE 172
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3041
Country	:	US
Telephone Number	:	888-920-0527
Fax Number	:	877-816-5523

Authorized Official
Title or Position	:	VP, PHARMACY OPERATIONS
Name	:	KEVIN BISCH
Credential	:	PHARMACIST
Telephone Number	:	267-251-6319

Provider Enumeration Date	:	03/19/2020
Last Update Date	:	01/05/2026

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