Organization
LIDDY'S PHARMACY, LLC
Active
Other names
Synergy Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA LIDDY (OWNER)
(863) 647-9899
Entity
Organization
Contact information
Practice address
4204 S FLORIDA AVE STE E, LAKELAND, FL 33813-1669
(863) 647-9899
(863) 709-0030
Mailing address
4204 S FLORIDA AVE STE E, LAKELAND, FL 33813-1669
(863) 647-9899
(863) 709-0030
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH19502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012171
NCPDP
FL
Enumeration date
07/11/2006
Last updated
01/22/2013
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