Organization
SILVER LAKE PHARMACY, LLC.
Active
Other names
SILVER LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAMLESH PATEL (PHARMACY MANAGER)
(352) 217-0487
Entity
Organization
Contact information
Practice address
32729 RADIO RD, LEESBURG, FL 34788-3900
(352) 217-0487
Mailing address
2705 COTTON CT, EUSTIS, FL 32726-2078
(352) 217-0487
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH27348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010760900
—
FL
Enumeration date
01/08/2014
Last updated
06/18/2014
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