MEDICARE: EXPRESSCARE PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336M0002X	Mail Order Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5702356	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1316257264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESSCARE PHARMACY INC

Provider Business Mailing Address
First Line	:	3340 GRIFFIN RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5519
Country	:	US
Telephone Number	:	954-399-8003
Fax Number	:	954-399-8009

Provider Business Practice Location Address
First Line	:	3340 GRIFFIN RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5519
Country	:	US
Telephone Number	:	954-399-8003
Fax Number	:	954-399-8009

Authorized Official
Title or Position	:	OWNER
Name	:	LEONEL PALATNIK
Credential	:
Telephone Number	:	786-252-5628

Provider Enumeration Date	:	10/13/2010
Last Update Date	:	11/03/2010

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Directions to “EXPRESSCARE PHARMACY INC ” Practice Location

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