Organization
LANTANA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES WILSON MBA (PRESIDENT)
(561) 964-7614
Entity
Organization
Contact information
Practice address
3206 LANTANA ROAD, LANTANA, FL 33462-2432
(561) 964-7614
(561) 964-7615
Mailing address
3206 LANTANA ROAD, LANTANA, FL 33462-2432
(561) 964-7614
(561) 964-7615
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH23129
FL
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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