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Organization
LAKE PLACID DRUG CO.
Active
Organization
LAKE PLACID DRUG CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D. STIDHAM RPH (OWNER/PHARMACIST)
(863) 465-2291
Entity
Organization
Contact information
Practice address
224 E INTERLAKE BLVD, LAKE PLACID, FL 33852-9603
(863) 465-2751
(863) 465-3977
Mailing address
224 E INTERLAKE BLVD, LAKE PLACID, FL 33852-9603
(863) 465-3977
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH659
FL
Other
Enumeration date
07/16/2005
Last updated
08/22/2020
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