Organization
VILLA PHARMACY LLC
Active
Other names
Villa Medical Health Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE JONES (PHARMACY MANAGER)
(863) 229-5978
Entity
Organization
Contact information
Practice address
105 AVENUE R NW, WINTER HAVEN, FL 33881-2147
(863) 229-5978
(863) 662-3953
Mailing address
105 AVENUE R NW, WINTER HAVEN, FL 33881-2147
(863) 229-5978
(863) 662-3953
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH2986
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158247
PK
—
Enumeration date
02/17/2016
Last updated
07/05/2016
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