Organization
EXTENDED CARE PHARMACY EAST INC
Active
Other names
EXTENDED CARE PHARMACY EAST inc
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CASEY PHILLIPS (CPT/OWNER)
(386) 326-4487
Entity
Organization
Contact information
Practice address
305 S US HIGHWAY 17, EAST PALATKA, FL 32131-4092
(386) 326-4487
(386) 326-4437
Mailing address
305 S US HIGHWAY 17, EAST PALATKA, FL 32131-4092
(386) 326-4487
(386) 326-4437
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26112
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5708118
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/10/2011
Last updated
08/07/2012
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