Organization
ICON PHARMACEUTICALS INC
Active
Other names
ICON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA LABREQUE (ASSOC EXEC)
(407) 872-7088
Entity
Organization
Contact information
Practice address
300 E CHURCH ST, ORLANDO, FL 32801-3544
(407) 649-8050
(407) 649-8051
Mailing address
300 E CHURCH ST, ORLANDO, FL 32801-3544
(407) 649-8050
(407) 649-8051
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH21554
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005354
PK
—
Enumeration date
09/11/2006
Last updated
11/07/2014
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