Medoz Pharmacy of Polk Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH28725 Issued in FL

Legal business name

MEDOZ PHARMACY OF POLK INC

Practice address

40230 US Highway 27
#100-110
Davenport, FL 33837

Phone

(855) 633-6948

Fax

(844) 329-6348

NPI assigned

Nov 26, 2014

Last updated

Nov 26, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Tushar Palan

Title

President

Phone

(855) 633-6948

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Udaykumar J Desai, B.PHARM

  • Pharmacist
  • Davenport, FL
  • NPI 1487612693
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1962809475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40230 US HIGHWAY 27",
            "address_2": "#100-110",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "855-633-6948",
            "fax_number": "844-329-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40230 US HIGHWAY 27",
            "address_2": "#100-110",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "855-633-6948",
            "fax_number": "844-329-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDOZ PHARMACY OF POLK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "PALAN",
        "authorized_official_first_name": "TUSHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-633-6948",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "FL",
            "license": "PH28725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "PH28725",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medical Home Alliance LLC
• Medical Home Alliance LLC (IMA Medical Group - Degnan)
• Marko Anthony Medina, PTA
• Mya Lucero Medina, CCC-SLP
• Tanairy Medina
• Medoz Pharmacy of Polk LLC
• Robyn Tracy Meers, APRN
• Andrew Dean Meikle, MD
• Jennifer Mejia
• Carmen D Melendez Torres

• Compounding Pharmacy in Davenport, FL
• Providers in Davenport, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.