Organization
MEDOZ PHARMACY OF POLK LLC
Active
Organization
MEDOZ PHARMACY OF POLK LLC
Active
Other names
f/k/a Medoz Pharmacy of Polk Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ABRAHAM MERMELSTEIN (MANAGING MEMBER)
(732) 267-7782
Entity
Organization
Contact information
Practice address
40230 US HIGHWAY 27 N, SUITE 100-110, DAVENPORT, FL 33837-2636
(855) 633-6948
(844) 329-6348
Mailing address
40230 US HIGHWAY 27 N, SUITE 100-110, DAVENPORT, FL 33837-2636
(855) 633-6948
(844) 329-6348
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH28722
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH28722
FL
3336C0004X
Compounding Pharmacy
PS28722
FL
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014712100
—
FL
01
—
PH28722
PHARMACY STATE LICENSE NUMBER
FL
Enumeration date
11/24/2014
Last updated
08/25/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up