MEDICARE: INTERNATIONAL 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	3336C0003X	Community/Retail Pharmacy

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

General Provider Information

NPI Number	:	1720478332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL PHARMACY INC

Provider Business Mailing Address
First Line	:	480 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4718
Country	:	US
Telephone Number	:	305-640-5466
Fax Number	:	305-640-5488

Provider Business Practice Location Address
First Line	:	480 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4718
Country	:	US
Telephone Number	:	305-640-5466
Fax Number	:	305-640-5488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERMAN ROCHE
Credential	:
Telephone Number	:	305-640-5466

Provider Enumeration Date	:	02/03/2015
Last Update Date	:	01/20/2023

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Directions to “INTERNATIONAL PHARMACY INC ” Practice Location

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