MEDICARE: A PLUS 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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1730847054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLUS PHARMACY LLC

Provider Business Mailing Address
First Line	:	12430 EDGEMERE BLVD STE 209
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4576
Country	:	US
Telephone Number	:	915-704-4333
Fax Number	:	915-704-4010

Provider Business Practice Location Address
First Line	:	12430 EDGEMERE BLVD STE 209
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4576
Country	:	US
Telephone Number	:	915-704-4333
Fax Number	:	915-704-4010

Authorized Official
Title or Position	:	PIC
Name	:	ANSLEM N ANENE
Credential	:
Telephone Number	:	502-644-5059

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	12/03/2021

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