Organization
CRESTMARK PHARMACY SERVICES, LLC
Active
Other names
Crestmark Pharmacy Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL MCELHENEY (MANAGER)
(850) 832-2773
Entity
Organization
Contact information
Practice address
1860 HIGHLAND OAKS BLVD, LUTZ, FL 33559-7353
(813) 428-6963
(813) 803-7503
Mailing address
1860 HIGHLAND OAKS BLVD, LUTZ, FL 33559-7353
(813) 428-6963
(813) 803-7503
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH28922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150516
PK
—
Enumeration date
03/12/2015
Last updated
03/12/2015
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