Organization
PINES DISCOUNT PHARMACY INC
Active
Other names
Kingsley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LEE DALY (PRESIDENT)
(561) 214-3828
Entity
Organization
Contact information
Practice address
2020 KINGSLEY AVE STE 2B, ORANGE PARK, FL 32073-5181
(904) 527-7330
(904) 527-7331
Mailing address
2020 KINGSLEY AVE STE 2B, ORANGE PARK, FL 32073-5181
(904) 527-7330
(904) 527-7331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24151
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030963000
—
FL
01
—
2004927
PK
—
Enumeration date
12/28/2006
Last updated
10/26/2021
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