MEDICARE: PAY LESS PHARMACY 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH23510	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1036462	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1184883431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAY LESS PHARMACY INC

Provider Business Mailing Address
First Line	:	7208 N STERLING AVE
Second Line	:	STE B
City	:	TAMPA
State	:	FL
Zip	:	33614-4051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7208 N STERLING AVE
Second Line	:	STE B
City	:	TAMPA
State	:	FL
Zip	:	33614-4051
Country	:	US
Telephone Number	:	813-933-5830
Fax Number	:	813-933-5841

Authorized Official
Title or Position	:	OWNER
Name	:	JOEL CASTELLON
Credential	:
Telephone Number	:	813-892-4026

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	04/15/2009

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Directions to “PAY LESS PHARMACY INC ” Practice Location

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