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Organization

SHANDS AT LAKE SHORE INC

Active
Parent organization
SHANDS AT LAKE SHORE INC
Other names
Shands Lake Shore Durable Medical Equipment
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHANDS AT LAKE SHORE INC
Authorized official
MS. JODI MANSFIELD (SR. VICE PRESIDENT & COO)
(352) 265-0440
Entity
Organization

Contact information

Practice address
368 NE FRANKLIN ST, LAKE CITY, FL 32055-3088
(386) 754-8000
(352) 733-0069
Mailing address
720 SW 2ND AVE, SUITE 360C, GAINESVILLE, FL 32601-6271
(352) 733-0060
(352) 733-0069

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
4258
FL

Other

Enumeration date
10/05/2006
Last updated
11/20/2007
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