MEDICARE: UNIVERSITY DRUGS LLC

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	PH23070	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1017486	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427029404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY DRUGS LLC

Provider Business Mailing Address
First Line	:	3220 COVE BEND DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 COVE BEND DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2752
Country	:	US
Telephone Number	:	813-615-0742
Fax Number	:	813-615-0782

Authorized Official
Title or Position	:	PHCY MANG
Name	:	MOIZ JANOOWALLA
Credential	:
Telephone Number	:	813-615-0742

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	12/05/2008

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Directions to “UNIVERSITY DRUGS LLC ” Practice Location

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