Organization
NORTH FLORIDA RECEPTION CENTER
Active
Other names
NORTH FLORIDA RECEPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MOULDER RPH (PHARMACY MANAGER)
(386) 496-6534
Entity
Organization
Contact information
Practice address
7765 S COUNTY ROAD 231, DEPT OF CORRECTIONS, LAKE BUTLER, FL 32054-5721
(386) 496-6532
(386) 496-6081
Mailing address
PO BOX 628, LAKE BUTLER, FL 32054-0628
(386) 496-6532
(386) 496-6081
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
PH2387
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005010
PK
—
Enumeration date
09/14/2007
Last updated
03/13/2015
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