MEDICARE: AM PHARMA 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	3336C0003X	Community/Retail Pharmacy	PH23390	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1035282	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1023284270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AM PHARMA LLC

Provider Business Mailing Address
First Line	:	1933 N PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-5780
Country	:	US
Telephone Number	:	727-944-5800
Fax Number	:	727-994-5844

Provider Business Practice Location Address
First Line	:	1933 THROUGH 1935 N PINELLAS AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689
Country	:	US
Telephone Number	:	727-944-5800
Fax Number	:	727-848-8330

Authorized Official
Title or Position	:	OWNER
Name	:	HARSH MEHTA
Credential	:	RPH
Telephone Number	:	727-944-5800

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	12/19/2009

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Directions to “AM PHARMA LLC ” Practice Location

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