Organization
LIFE SPECIALTY PHARMACY MEDICAL EQUIPMENT AND SUPPLIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL AYOTUNDE (PRESIDENT OWNER)
(407) 522-5683
Entity
Organization
Contact information
Practice address
1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL 32835-5795
(407) 405-0735
(407) 522-5684
Mailing address
1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL 32835-5795
(407) 522-5683
(407) 522-5684
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH 22346
FL
3336C0002X
Clinic Pharmacy
PH 22346
FL
3336C0004X
Compounding Pharmacy
PH 22346
FL
3336H0001X
Home Infusion Therapy Pharmacy
PH 22346
FL
3336I0012X
Institutional Pharmacy
PH 22346
FL
3336L0003X
Long Term Care Pharmacy
PH 22346
FL
3336M0002X
Mail Order Pharmacy
PH 22346
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031807800
—
FL
01
—
1659441624
NPI
FL
Enumeration date
11/08/2006
Last updated
06/05/2008
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