MEDICARE: S A S B INC

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	PH8238	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063419372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S A S B INC

Provider Business Mailing Address
First Line	:	203 SW PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-4160
Country	:	US
Telephone Number	:	863-763-5100
Fax Number	:	863-763-7550

Provider Business Practice Location Address
First Line	:	203 SW PARK ST
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-4160
Country	:	US
Telephone Number	:	863-763-5100
Fax Number	:	863-763-7550

Authorized Official
Title or Position	:	CEO PRES
Name	:	MR. STEVEN DAVID NELSON
Credential	:	RPH CPH
Telephone Number	:	863-763-5100

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	01/20/2022

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Directions to “S A S B INC ” Practice Location

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