Healthcare Provider Details

I. General information

NPI: 1649277641
Provider Name (Legal Business Name): MELROSE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8744 STATE ROAD 21
MELROSE FL
32666-8809
US

IV. Provider business mailing address

8744 STATE ROAD 21
MELROSE FL
32666-8809
US

V. Phone/Fax

Practice location:
  • Phone: 352-475-3919
  • Fax: 352-475-1467
Mailing address:
  • Phone: 352-475-3919
  • Fax: 352-475-1467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberBM7562172
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberBM7562172
License Number StateFL

VIII. Authorized Official

Name: HOWARD W ECKENRODE
Title or Position: PHARMACIST/OWNER
Credential: RPH
Phone: 352-475-3919