Organization
MULBERRY PHARMACY INC
Active
Other names
MULBERRY PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JEROLD SLAUGHTER RPH (OWNER CEO)
(863) 425-1101
Entity
Organization
Contact information
Practice address
1009 N CHURCH AVE, MULBERRY, FL 33860-2039
(863) 425-1101
(863) 425-1497
Mailing address
PO BOX 767, MULBERRY, FL 33860-0767
(863) 425-1101
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH0001028
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100004700
—
FL
01
—
2005824
PK
—
Enumeration date
09/20/2006
Last updated
04/04/2017
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