Healthcare Provider Details

I. General information

NPI: 1790025609
Provider Name (Legal Business Name): MEDTOWN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24333 ALABAMA HWY 24, SUITE A
TRINITY AL
35673
US

IV. Provider business mailing address

5420 NW 33RD AVE, SUITE 7A ATTN: COMPLIANCE
FORT LAUDERDALE FL
33309
US

V. Phone/Fax

Practice location:
  • Phone: 800-246-2677
  • Fax: 702-866-2689
Mailing address:
  • Phone: 954-921-4661
  • Fax: 954-921-0484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number114042
License Number StateAL

VIII. Authorized Official

Name: PARAG D CHOSKI
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 954-921-4661