Organization
HEARTLAND PHARMACY LAKE PLACID
Active
Other names
Heartland Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CARIN BRALTS PHARMD (OWNER/PRESIDENT)
(863) 449-1006
Entity
Organization
Contact information
Practice address
342 E ROYAL PALM ST, LAKE PLACID, FL 33852-5019
(863) 659-1780
(863) 659-1786
Mailing address
342 E ROYAL PALM ST, LAKE PLACID, FL 33852-5019
(863) 659-1780
(863) 659-1786
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26570
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008053900
—
FL
01
—
2138527
PK
—
Enumeration date
12/31/2012
Last updated
03/01/2017
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