Organization
LAKE CITY PHARMACY INC
Active
Other names
LAKE CITY PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL ERIC ROSENFELD RPH (OWNER/MANAGER)
(386) 758-6770
Entity
Organization
Contact information
Practice address
376 SW ALACHUA AVE, LAKE CITY, FL 32025-5201
(386) 758-3460
(386) 758-3462
Mailing address
376 SW ALACHUA AVE, LAKE CITY, FL 32025-5201
(386) 758-3460
(386) 758-3462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH21845
FL
3336L0003X
Long Term Care Pharmacy
Primary
PH21845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031645801
—
FL
01
—
1018616
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/23/2006
Last updated
07/16/2009
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