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Organization
EXTENDED CARE PHARMACY, INC.
Active
Organization
EXTENDED CARE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK CASEY PHILLIPS (VICE PRESIDENT)
(386) 325-5505
Entity
Organization
Contact information
Practice address
6400 CRILL AVE, PALATKA, FL 32177-3876
(386) 325-5505
(386) 328-9393
Mailing address
6400 CRILL AVE, PALATKA, FL 32177-3876
(386) 325-5505
(386) 328-9393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032497300
—
FL
01
—
1088803
NCPDP
FL
Enumeration date
06/28/2005
Last updated
08/07/2012
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