Organization
HARRIETH N ALADIUME
Active
Other names
EDGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ABIY TEKLE PHARMD (PHARMACIST/MANAGER)
(339) 224-0842
Entity
Organization
Contact information
Practice address
2039 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 937-1050
(863) 937-1055
Mailing address
2039 E EDGEWOOD DR, LAKELAND, FL 33803-3601
(863) 937-1050
(863) 937-1055
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001428600
—
FL
01
—
2121191
PK
—
Enumeration date
07/23/2009
Last updated
01/20/2015
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