MEDICARE: CALAN PHARMACY & DISCOUNT SERVICE, 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	PH25770	FL

General Provider Information

NPI Number	:	1033483169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALAN PHARMACY & DISCOUNT SERVICE, LLC

Provider Business Mailing Address
First Line	:	1879 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	305-643-2001
Fax Number	:	305-643-2003

Provider Business Practice Location Address
First Line	:	1879 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-1939
Country	:	US
Telephone Number	:	305-643-2001
Fax Number	:	305-643-2003

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. ARTURO ALBERTO OMS
Credential	:
Telephone Number	:	305-643-2001

Provider Enumeration Date	:	03/07/2012
Last Update Date	:	03/07/2012

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