Organization
MEDOZ PHARMACY OF OSCEOLA INC
Active
Organization
MEDOZ PHARMACY OF OSCEOLA INC
Active
Other names
MEDOZ PHARMACY OF OSCEOLA INC
Organization subpart
No
Provider details
NPI number
Authorized official
UDAYKUMAR DESAI (CEO)
(407) 374-2550
Entity
Organization
Contact information
Practice address
720 W OAK ST, STE 114, KISSIMMEE, FL 34741-4989
(407) 374-2550
(407) 347-4097
Mailing address
720 W OAK ST, STE 114, KISSIMMEE, FL 34741-4989
(407) 374-2550
(407) 347-4097
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24831
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106499034
—
FL
01
—
5701556
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/01/2010
Last updated
09/17/2012
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