Organization
BIG LAKE PHARMACY INC
Active
Other names
BIG LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN NELSON RPH/CPH (CEO/PRES)
(863) 634-4002
Entity
Organization
Contact information
Practice address
203 SW PARK ST, STE B, OKEECHOBEE, FL 34972-4160
(863) 763-1339
(863) 763-1487
Mailing address
203 SW PARK ST, STE B, OKEECHOBEE, FL 34972-4160
(863) 763-1339
(863) 763-1487
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH18708
FL
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031557500
—
FL
01
—
1096785
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/18/2006
Last updated
10/09/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up