Organization
MULBERRY LTC PHARMACY, LLC
Active
Other names
MULBERRY PHARMACY INC.
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY LYNN PRESTON (VICE PRESIDENT)
(863) 425-1101
Entity
Organization
Contact information
Practice address
1011 N CHURCH AVE, MULBERRY, FL 33860-2039
(863) 425-1101
(863) 425-2802
Mailing address
PO BOX 797, MULBERRY, FL 33860-0797
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
PH22964
FL
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032380200
—
FL
01
—
2010229
PK
—
Enumeration date
11/08/2007
Last updated
07/21/2022
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