Provider Demographics
NPI:1720501547
Name:EXPRESS CARE PHARMACY LLC
Entity Type:Organization
Organization Name:EXPRESS CARE PHARMACY LLC
Other - Org Name:EXPRESS CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MCSHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-309-7246
Mailing Address - Street 1:777 SHOTGUN ROAD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1940
Mailing Address - Country:US
Mailing Address - Phone:800-309-7246
Mailing Address - Fax:866-310-5710
Practice Address - Street 1:777 SHOTGUN ROAD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1940
Practice Address - Country:US
Practice Address - Phone:800-309-7246
Practice Address - Fax:866-310-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH311213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170641OtherPK