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NPI Code Detail

MEDICARE: REALO SPECIALTY CARE PHARMACY, LLC

MEDICARE: REALO SPECIALTY CARE PHARMACY, 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
1332B00000XDurable Medical Equipment & Medical Supplies
23336S0011XSpecialty Pharmacy
33336C0003XCommunity/Retail Pharmacy12602NC
4333600000XPharmacy
53336H0001XHome Infusion Therapy Pharmacy

General Provider Information

NPI Number : 1730573098
Entity Type Code : Organization
Provider Name (Legal Business Name) : REALO SPECIALTY CARE PHARMACY, LLC
Provider Business Mailing Address
First Line : 2801 NETWORK BLVD STE 505
Second Line :
City : FRISCO
State : TX
Zip : 75034-1895
Country : US
Telephone Number : 833-765-3648
Fax Number : 603-718-3824
Provider Business Practice Location Address
First Line : 860 AVIATION PKWY STE 1400
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-7399
Country : US
Telephone Number : 844-814-1943
Fax Number : 844-814-1944
Authorized Official
Title or Position : CEO AND PRESIDENT
Name : MR. ANDREW C. WALK
Credential :
Telephone Number : 833-765-3648
Provider Enumeration Date : 03/25/2015
Last Update Date : 06/03/2026

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Directions to “REALO SPECIALTY CARE PHARMACY, LLC ” Practice Location

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