Provider Demographics
NPI:1942319629
Name:MEDIC PHARMACY INC
Entity Type:Organization
Organization Name:MEDIC PHARMACY INC
Other - Org Name:MEDIC PRESCRIPTION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-484-4200
Mailing Address - Street 1:5150 N FEDERAL HWY
Mailing Address - Street 2:REAR
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3814
Mailing Address - Country:US
Mailing Address - Phone:954-484-4200
Mailing Address - Fax:954-484-8678
Practice Address - Street 1:5150 N FEDERAL HWY
Practice Address - Street 2:REAR
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3814
Practice Address - Country:US
Practice Address - Phone:954-484-4200
Practice Address - Fax:954-484-8678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH88173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104346301Medicaid
FL678737100Medicaid
FL104346300Medicaid
2005785OtherPK
FL678737100Medicaid