Organization
LAKE EXPRESS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUHAMMAD ILYAS (OWNER)
(561) 523-4161
Entity
Organization
Contact information
Practice address
25 DR MLK BLVD E STE B, BELLE GLADE, FL 33430-4044
(561) 523-4161
Mailing address
6308 GREBE CT, LAKE WORTH, FL 33463-9314
(561) 523-4161
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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