MEDICARE: RX HEALTH PHARMACY 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	PH22805	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1027742	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1982895165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX HEALTH PHARMACY INC

Provider Business Mailing Address
First Line	:	9361 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4159
Country	:	US
Telephone Number	:	305-227-5842
Fax Number	:	305-227-5843

Provider Business Practice Location Address
First Line	:	9361 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4159
Country	:	US
Telephone Number	:	305-227-5842
Fax Number	:	305-227-5843

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAYERLIS LOPEZ
Credential	:
Telephone Number	:	305-726-5997

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	12/03/2012

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