MEDICARE: DAMOL INC

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	PH24862	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	:	1962719211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAMOL INC

Provider Business Mailing Address
First Line	:	620 S LAKE ST
Second Line	:	SUITE4
City	:	LEESBURG
State	:	FL
Zip	:	34748-6059
Country	:	US
Telephone Number	:	352-460-4030
Fax Number	:	352-460-4137

Provider Business Practice Location Address
First Line	:	620 S LAKE ST
Second Line	:	SUITE4
City	:	LEESBURG
State	:	FL
Zip	:	34748-6059
Country	:	US
Telephone Number	:	352-460-4030
Fax Number	:	352-460-4137

Authorized Official
Title or Position	:	PHARMACIST
Name	:	CARL ALLISION
Credential	:
Telephone Number	:	352-460-4030

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	03/13/2025

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Directions to “DAMOL INC ” Practice Location

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