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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