MEDICARE: INTRAMED 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
2	3336C0003X	Community/Retail Pharmacy	PH18245	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2014178	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730183310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTRAMED INC

Provider Business Mailing Address
First Line	:	6950 CYPRESS RD
Second Line	:	SUITE 105
City	:	PLANTATION
State	:	FL
Zip	:	33317-2382
Country	:	US
Telephone Number	:	954-316-5054
Fax Number	:	954-797-9205

Provider Business Practice Location Address
First Line	:	6950 CYPRESS RD STE 105
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2361
Country	:	US
Telephone Number	:	866-999-0904
Fax Number	:	866-999-0905

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAWRENCE PIZIK
Credential	:
Telephone Number	:	984-214-7982

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/27/2022

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Directions to “INTRAMED INC ” Practice Location

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