MEDICARE: ALTO PHARMACY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336S0011X	Specialty Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHAR.CF.61006836	OTHER	WA	PHARMACY PERMIT
2	4939421	OTHER		NCPDP

General Provider Information

NPI Number	:	1033755731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTO PHARMACY, LLC

Provider Business Mailing Address
First Line	:	8407 FIREBIRD DR STE 300
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45014-2348
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Provider Business Practice Location Address
First Line	:	2821 NORTHUP WAY STE 150
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-1439
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:	415-484-7058

Authorized Official
Title or Position	:	SR. MANAGER OF REIMBURSEMENT
Name	:	LAUREN HAMMOND
Credential	:
Telephone Number	:	800-874-5881

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	05/27/2026

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