MEDICARE: PILLS 4 LESS 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	60006620A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2170249	OTHER		PK

General Provider Information

NPI Number	:	1992229249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILLS 4 LESS LLC

Provider Business Mailing Address
First Line	:	513 RIDGE RD SUITE #2
Second Line	:	513 RIDGE RD SUITE #2
City	:	MUNSTER
State	:	IN
Zip	:	46321
Country	:	US
Telephone Number	:	844-745-5748
Fax Number	:	844-745-5748

Provider Business Practice Location Address
First Line	:	513 RIDGE RD STE 2
Second Line	:	513 RIDGE RD SUITE 2
City	:	MUNSTER
State	:	IN
Zip	:	46321-1648
Country	:	US
Telephone Number	:	844-745-5748
Fax Number	:	844-745-5748

Authorized Official
Title or Position	:	PIC
Name	:	OMAR HASSAD
Credential	:
Telephone Number	:	219-515-0150

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	07/28/2017

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Directions to “PILLS 4 LESS LLC ” Practice Location

Language	Start Address	Practice Location

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