Organization
WELAKA PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA LONG (V.P.)
(386) 698-3737
Entity
Organization
Contact information
Practice address
698 THIRD AVENUE, WELAKA, FL 32193-0780
(386) 467-9994
(386) 467-3112
Mailing address
PO BOX 780, WELAKA, FL 32193-0780
(386) 467-9994
(386) 467-3112
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH16228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106512200
—
FL
01
—
P7787
BCBSFL
FL
Enumeration date
12/23/2005
Last updated
02/20/2009
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