Organization
HRS CITRUS COUNTY HEALTH DEPT. PHARMACY
Active
Organization
HRS CITRUS COUNTY HEALTH DEPT. PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA L. GOODMAN ARNP, PHD (COUNTY HEALTH DEPARTMENT ADMINISTRA)
(352) 527-0068
Entity
Organization
Contact information
Practice address
2804 MARC KNIGHTON CT, LECANTO, FL 34461
(352) 527-0068
Mailing address
2804 MARC KNIGHTON CT, BIN 14, LECANTO, FL 34461
(352) 249-9258
(352) 527-3013
Taxonomy
Speciality
Code
Description
License number
State
332000000X
Military/U.S. Coast Guard Pharmacy
PH 13705
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH24681
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103381600
—
FL
01
—
PH 13705
COMMUNITY PHARMACY LICENS
FL
Enumeration date
10/02/2006
Last updated
03/07/2023
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