MEDICARE: EXPRESS SCRIPTS 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	333600000X	Pharmacy
2	3336M0002X	Mail Order Pharmacy	28RS00732400.	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2145183	OTHER		PK

General Provider Information

NPI Number	:	1417376765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS SCRIPTS PHARMACY INC

Provider Business Mailing Address
First Line	:	2040 ROUTE 130
Second Line	:
City	:	FLORENCE
State	:	NJ
Zip	:	08518
Country	:	US
Telephone Number	:	800-283-8609
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 ROUTE 130
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-9716
Country	:	US
Telephone Number	:	800-283-8609
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	SUSAN PEPPERS
Credential	:
Telephone Number	:	513-858-4916

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	12/05/2025

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Directions to “EXPRESS SCRIPTS PHARMACY INC ” Practice Location

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