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Organization
NORTH FLORIDA RECEPTION CENTER
Active
Organization
NORTH FLORIDA RECEPTION CENTER
Active
Other names
NORTH FLORIDA RECEPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MOULDER RPH (PHARMACY MANAGER)
(386) 496-6534
Entity
Organization
Contact information
Practice address
7765 S COUNTY ROAD 231, DEPT OF CORRECTIONS, LAKE BUTLER, FL 32054-5721
(386) 496-6532
(386) 496-6081
Mailing address
PO BOX 628, LAKE BUTLER, FL 32054-0628
(386) 496-6532
(386) 496-6081
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
PH2387
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005010
PK
—
Enumeration date
09/14/2007
Last updated
03/13/2015
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