MEDICARE: PHARMACON, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3336S0011X	Specialty Pharmacy
2	2080P0207X	Pediatric Hematology & Oncology Physician
3	3336L0003X	Long Term Care Pharmacy
4	2080P0206X	Pediatric Gastroenterology Physician

General Provider Information

NPI Number	:	1437154051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACON, INC.

Provider Business Mailing Address
First Line	:	160 SW 12TH AVE
Second Line	:	STE 101D
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-3114
Country	:	US
Telephone Number	:	954-725-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 SW 12TH AVE
Second Line	:	STE 101D
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-3114
Country	:	US
Telephone Number	:	954-725-0222
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RICHARD D MOSS
Credential	:
Telephone Number	:	954-725-0222

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/30/2023

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Directions to “PHARMACON, INC. ” Practice Location

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