Organization
LAKELAND FAMILY PHARMACY
Active
Other names
Lakeland Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY CLAY (MANAGING PARTNER)
(863) 619-5269
Entity
Organization
Contact information
Practice address
3655 INNOVATION DR, LAKELAND, FL 33812-4106
(863) 644-5415
(863) 644-2915
Mailing address
3655 INNOVATION DR, LAKELAND, FL 33812-4106
(863) 644-5415
(863) 644-2915
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH29146
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153464
PK
—
Enumeration date
08/07/2015
Last updated
08/07/2015
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