MEDICARE: NABE PHARMACY, 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	3336S0011X	Specialty Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467026724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NABE PHARMACY, LLC

Provider Business Mailing Address
First Line	:	8751 NW 157TH TER
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33018-1412
Country	:	US
Telephone Number	:	305-527-3189
Fax Number	:	954-827-0868

Provider Business Practice Location Address
First Line	:	906 W SUNRISE BLVD STE B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7131
Country	:	US
Telephone Number	:	954-368-6626
Fax Number	:	954-827-0868

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERALDO RODRIGUEZ
Credential	:
Telephone Number	:	954-368-6626

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	08/03/2024

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Directions to “NABE PHARMACY, LLC ” Practice Location

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