MEDICARE: A PLUS PHARMACY & MEDICAL SUPPLY

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	PH30690	FL
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	PH30690	FL
3	3336S0011X	Specialty Pharmacy	PH30690	FL
4	333600000X	Pharmacy	PH30690	FL

General Provider Information

NPI Number	:	1225564107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLUS PHARMACY & MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	1303 SE 17TH ST
Second Line	:	SUITE D1
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1722
Country	:	US
Telephone Number	:	954-687-0774
Fax Number	:	954-752-3989

Provider Business Practice Location Address
First Line	:	1303 SE 17TH ST
Second Line	:	SUITE D1
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1722
Country	:	US
Telephone Number	:	954-687-0774
Fax Number	:	954-752-3989

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	MR. ANTOINE MOURANI
Credential	:	RPH
Telephone Number	:	954-687-0774

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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