MEDICARE: LATO DRUG COMPANY 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0004X	Compounding Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PH11884	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2004369	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710986203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATO DRUG COMPANY INC

Provider Business Mailing Address
First Line	:	4401 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	954-989-6524
Fax Number	:	954-985-8239

Provider Business Practice Location Address
First Line	:	4401 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3513
Country	:	US
Telephone Number	:	954-989-6524
Fax Number	:	954-985-8239

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT FISHMAN
Credential	:
Telephone Number	:	954-989-6524

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	02/20/2017

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Directions to “LATO DRUG COMPANY INC ” Practice Location

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