MEDICARE: AKDM RX 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)
3	3336C0003X	Community/Retail Pharmacy	PH998	FL

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

General Provider Information

NPI Number	:	1467470336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKDM RX LLC

Provider Business Mailing Address
First Line	:	1777 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4732
Country	:	US
Telephone Number	:	305-947-0433
Fax Number	:	855-647-1321

Provider Business Practice Location Address
First Line	:	1777 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4732
Country	:	US
Telephone Number	:	305-947-0433
Fax Number	:	855-647-1321

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	SALAR HABIBI
Credential	:	PHARM. D
Telephone Number	:	305-947-0433

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	02/02/2024

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Directions to “AKDM RX LLC ” Practice Location

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