Organization
LEGACY PHARMACY OC LLC
Active
Other names
Legacy Pharmacy OC
Organization subpart
No
Provider details
NPI number
Authorized official
DIPTIBEN SMART (PHARMACY MANAGER)
(386) 218-4993
Entity
Organization
Contact information
Practice address
921 TOWN CENTER DR STE 100, ORANGE CITY, FL 32763-8266
(386) 218-4993
(386) 218-4913
Mailing address
921 TOWN CENTER DR STE 100, ORANGE CITY, FL 32763-8266
(386) 218-4993
(386) 218-4913
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/04/2023
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