MEDICARE: METROMEDS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	PH26329	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
2	2139000	OTHER		PK

General Provider Information

NPI Number	:	1508115890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROMEDS PHARMACY LLC

Provider Business Mailing Address
First Line	:	409 E MICHIGAN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-4541
Country	:	US
Telephone Number	:	321-888-2222
Fax Number	:	321-888-3999

Provider Business Practice Location Address
First Line	:	409 E MICHIGAN ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-4541
Country	:	US
Telephone Number	:	321-888-2222
Fax Number	:	321-888-3999

Authorized Official
Title or Position	:	MANAGER
Name	:	AMGAD ESTAFAN
Credential	:
Telephone Number	:	321-888-2222

Provider Enumeration Date	:	09/03/2012
Last Update Date	:	06/17/2024

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Directions to “METROMEDS PHARMACY LLC ” Practice Location

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