Organization
LAKELAND FAMILY PHARMACY
Active
Organization
LAKELAND FAMILY PHARMACY
Active
Other names
Lakeland Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY CLAY (OWNER/MANAGER)
(863) 698-7260
Entity
Organization
Contact information
Practice address
605 W MEMORIAL BLVD, LAKELAND, FL 33815-1466
(863) 698-7260
Mailing address
605 W. MEMORIAL BLVD, LAKELAND, FL 32815
(863) 698-7260
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH27609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147296
PK
—
Enumeration date
08/20/2014
Last updated
08/20/2014
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