MEDICARE: EAGLE PHARMACY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	333600000X	Pharmacy	FL
2	3336M0002X	Mail Order Pharmacy
3	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1487905840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE PHARMACY LLC

Provider Business Mailing Address
First Line	:	350 EAGLES LANDING DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-2999
Country	:	US
Telephone Number	:	855-748-2663
Fax Number	:	863-279-1293

Provider Business Practice Location Address
First Line	:	350 EAGLES LANDING DR.
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-2899
Country	:	US
Telephone Number	:	855-748-2663
Fax Number	:	863-686-5682

Authorized Official
Title or Position	:	VP, PHARMACY OPERATIONS
Name	:	KEVIN BISCH
Credential	:	PHARMACIST
Telephone Number	:	267-251-6319

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	01/05/2026

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