MEDICARE: REDIRECT PBM, 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1710794631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDIRECT PBM, LLC

Provider Business Mailing Address
First Line	:	2020 N CENTRAL AVE STE 400
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-4510
Country	:	US
Telephone Number	:	602-687-2276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 N CENTRAL AVE STE 400
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-4510
Country	:	US
Telephone Number	:	602-687-2276
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DAVID BERG
Credential	:
Telephone Number	:	623-521-9406

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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Directions to “REDIRECT PBM, LLC ” Practice Location

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