MEDICARE: FOREST HILL 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	3336C0004X	Compounding Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH28218	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2151318	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033230982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST HILL PHARMACY LLC

Provider Business Mailing Address
First Line	:	2939 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5962
Country	:	US
Telephone Number	:	561-965-4288
Fax Number	:	561-965-1787

Provider Business Practice Location Address
First Line	:	2939 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5962
Country	:	US
Telephone Number	:	561-965-4288
Fax Number	:	561-965-1787

Authorized Official
Title or Position	:	OWNER / MANAGER
Name	:	RYAN GOODKIN
Credential	:
Telephone Number	:	561-543-4440

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	05/01/2017

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Directions to “FOREST HILL PHARMACY LLC ” Practice Location

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