MEDICARE: AC 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	3336C0003X	Community/Retail Pharmacy	PH22761	FL

General Provider Information

NPI Number	:	1346449246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AC PHARMACY INC

Provider Business Mailing Address
First Line	:	3964-1 CURTISS PARKWAY
Second Line	:
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166
Country	:	US
Telephone Number	:	305-870-0979
Fax Number	:	305-870-0978

Provider Business Practice Location Address
First Line	:	3964 CURTISS PKWY
Second Line	:	BAY 1
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-7108
Country	:	US
Telephone Number	:	305-870-0979
Fax Number	:	305-870-0978

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARIEL CORRAL
Credential	:
Telephone Number	:	305-870-0979

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	06/12/2008

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