MEDICARE: MELROSE PHARMACY, INC.

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	333600000X	Pharmacy	BM7562172	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies	BM7562172	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R9537	OTHER	FL	BCBS PROVIDER #

General Provider Information

NPI Number	:	1649277641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELROSE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	8744 STATE ROAD 21
Second Line	:
City	:	MELROSE
State	:	FL
Zip	:	32666-8809
Country	:	US
Telephone Number	:	352-475-3919
Fax Number	:	352-475-1467

Provider Business Practice Location Address
First Line	:	8744 STATE ROAD 21
Second Line	:
City	:	MELROSE
State	:	FL
Zip	:	32666-8809
Country	:	US
Telephone Number	:	352-475-3919
Fax Number	:	352-475-1467

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	HOWARD W ECKENRODE
Credential	:	RPH
Telephone Number	:	352-475-3919

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	09/11/2025

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Directions to “MELROSE PHARMACY, INC. ” Practice Location

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