MEDICARE: GENERIC SPECIALTIES 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	3336I0012X	Institutional Pharmacy

General Provider Information

NPI Number	:	1326462946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERIC SPECIALTIES INC

Provider Business Mailing Address
First Line	:	8007 HORSE FERRY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5977
Country	:	US
Telephone Number	:	407-445-9581
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 ACME ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32805-3603
Country	:	US
Telephone Number	:	407-445-9581
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ASHWIN ARVIND MEHTA
Credential	:
Telephone Number	:	407-445-9581

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	02/18/2014

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Directions to “GENERIC SPECIALTIES INC ” Practice Location

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