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NPI Code Detail

MEDICARE: MD OMEGA PHARMACY

MEDICARE: MD OMEGA PHARMACY
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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPH22846FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22009668OTHERPK

General Provider Information

NPI Number : 1235323098
Entity Type Code : Organization
Provider Name (Legal Business Name) : MD OMEGA PHARMACY
Provider Business Mailing Address
First Line : 4915 S DIXIE HWY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33405-2926
Country : US
Telephone Number : 561-547-7710
Fax Number : 561-547-7719
Provider Business Practice Location Address
First Line : 4915 S DIXIE HWY
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33405-2926
Country : US
Telephone Number : 561-547-7710
Fax Number : 561-547-7719
Authorized Official
Title or Position : CO-OWNER/ TREASURER
Name : ROSA CASTRO
Credential : RPT
Telephone Number : 561-547-7710
Provider Enumeration Date : 09/04/2007
Last Update Date : 02/20/2017

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Directions to “MD OMEGA PHARMACY ” Practice Location

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