Organization
SUN AND LAKE PHARMACY SERVICES, INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
KWAME FOSU RPH (OWNER PHARMACIST)
(863) 688-5427
Entity
Organization
Contact information
Practice address
1231 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4673
(863) 688-5427
(863) 688-5462
Mailing address
1231 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4673
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
BP121476
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030900100
—
FL
01
—
1013767
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/30/2007
Last updated
03/07/2023
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