MEDICARE: BOOTS 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	3336L0003X	Long Term Care 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	:	1811430945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOOTS LLC

Provider Business Mailing Address
First Line	:	7326 ROYAL PALM BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-6804
Country	:	US
Telephone Number	:	954-317-3688
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 NE 125TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4754
Country	:	US
Telephone Number	:	305-677-1221
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STEPHEN BANJOKO
Credential	:
Telephone Number	:	212-257-0225

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	07/30/2025

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Directions to “BOOTS LLC ” Practice Location

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