Organization
DLKA HOLDINGS, LLC
Active
Parent organization
DLKA HOLDKINGS, LLC
Other names
MORTAR AND PESTLE PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
DLKA HOLDKINGS, LLC
Authorized official
MR. XXXXXXXXXXX XXXXXXXX (XXXXXXXXXXXXXXXX)
(407) 288-8836
Entity
Organization
Contact information
Practice address
1361 E OSCEOLA PKWY, KISSIMMEE, FL 34744-1605
(407) 288-8836
(407) 846-0111
Mailing address
1361 E OSCEOLA PKWY, KISSIMMEE, FL 34744-1605
(407) 288-8836
(407) 846-0111
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24338
FL
3336S0011X
Specialty Pharmacy
PH24338
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003929100
—
FL
01
—
5706556
NCPDP PROVIDER IDENTIFICATION NUMBER
FL
Enumeration date
06/20/2011
Last updated
12/30/2012
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