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NPI Code Detail

MEDICARE: PACIFIC PHARMACY INC

MEDICARE: PACIFIC 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
13336C0003XCommunity/Retail PharmacyPH22281FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12129378OTHERPK

General Provider Information

NPI Number : 1720156599
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC PHARMACY INC
Provider Business Mailing Address
First Line : 8876 SW 24TH ST # 11
Second Line :
City : MIAMI
State : FL
Zip : 33165-2008
Country : US
Telephone Number : 305-226-5463
Fax Number : 305-226-5465
Provider Business Practice Location Address
First Line : 8876 SW 24TH ST # 11
Second Line :
City : MIAMI
State : FL
Zip : 33165-2008
Country : US
Telephone Number : 305-226-5463
Fax Number : 305-226-5465
Authorized Official
Title or Position : MANAGER
Name : SCOTT NOVICK
Credential :
Telephone Number : 305-226-5464
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/18/2013

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Directions to “PACIFIC PHARMACY INC ” Practice Location

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