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Organization
EXP PHARMACY SVC OF FL LLC
Active
Organization
EXP PHARMACY SVC OF FL LLC
Active
Other names
PHARMACARE DIRECT
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MEDURE RPH (GM)
(800) 589-7255
Entity
Organization
Contact information
Practice address
8275 BRYAN DAIRY RD, LARGO, FL 33777-1324
(800) 589-7255
(727) 395-7892
Mailing address
8275 BRYAN DAIRY RD, LARGO, FL 33777-1324
(800) 589-7255
(727) 395-7892
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
PH20840
FL
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106251400
—
FL
01
—
1075058
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
04/23/2010
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