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Organization

POLK CITY PHARMACY INC

Active
Other names
MEDICINE SHOPPE
Organization subpart
No

Provider details

NPI number
Authorized official
JACQUELINE A FUTCH PHARMD (OWNER PHARMACIST)
(863) 984-9631
Entity
Organization

Contact information

Practice address
108 N COMMONWEALTH AVE, POLK CITY, FL 33868-9506
(863) 984-3427
(863) 984-9631
Mailing address
108 N COMMONWEALTH AVE, POLK CITY, FL 33868-9506

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH21515
FL
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053987
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
10/02/2006
Last updated
03/07/2023
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