MEDICARE: ADVANCE PHARMACY 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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1134089287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE PHARMACY SERVICE LLC

Provider Business Mailing Address
First Line	:	4907 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1401
Country	:	US
Telephone Number	:	810-394-5416
Fax Number	:	810-394-5416

Provider Business Practice Location Address
First Line	:	4907 N ARMENIA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1401
Country	:	US
Telephone Number	:	810-394-5416
Fax Number	:	810-394-5416

Authorized Official
Title or Position	:	AM
Name	:	WALID OSMAN
Credential	:
Telephone Number	:	813-350-9999

Provider Enumeration Date	:	11/12/2025
Last Update Date	:	12/15/2025

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