MEDICARE: ALL MED PHARMCY

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
2	3336C0003X	Community/Retail Pharmacy	PH30237	FL

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	:	1891231965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL MED PHARMCY

Provider Business Mailing Address
First Line	:	1044 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5377
Country	:	US
Telephone Number	:	772-400-5877
Fax Number	:

Provider Business Practice Location Address
First Line	:	1044 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5377
Country	:	US
Telephone Number	:	772-400-5877
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHANDA SHAFFER- GRIFFITHS
Credential	:
Telephone Number	:	772-400-5877

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	12/09/2020

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Directions to “ALL MED PHARMCY ” Practice Location

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