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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