Organization
WEST LAKE PHARMACY INC
Active
Other names
WEST LAKE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NAPOLEON ONYECHI (MANAGER)
(407) 344-4555
Entity
Organization
Contact information
Practice address
2544 SIMPSON RD, KISSIMMEE, FL 34744-4637
(407) 344-4555
(407) 344-4566
Mailing address
2544 SIMPSON RD, KISSIMMEE, FL 34744-4637
(407) 344-4555
(407) 344-4566
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003526500
—
FL
01
—
2130063
PK
—
Enumeration date
03/18/2011
Last updated
08/20/2015
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