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NPI Code Detail

MEDICARE: ANGELS PHARMACY II LLC

MEDICARE: ANGELS PHARMACY II 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
13336C0003XCommunity/Retail PharmacyPH29527FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12154912OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750753935
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELS PHARMACY II LLC
Provider Business Mailing Address
First Line : 259 E MICHIGAN ST
Second Line :
City : ORLANDO
State : FL
Zip : 32806-4537
Country : US
Telephone Number : 551-358-4242
Fax Number : 888-855-1807
Provider Business Practice Location Address
First Line : 610 ZEAGLER DR
Second Line :
City : PALATKA
State : FL
Zip : 32177-3811
Country : US
Telephone Number : 407-426-7000
Fax Number : 888-855-1807
Authorized Official
Title or Position : PRESIDENT
Name : RAJENDRA PATEL
Credential :
Telephone Number : 551-358-4242
Provider Enumeration Date : 10/27/2015
Last Update Date : 06/23/2016

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Directions to “ANGELS PHARMACY II LLC ” Practice Location

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