Organization
MEDCENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J ANDERSON (PRESIDENT)
(863) 648-4600
Entity
Organization
Contact information
Practice address
6935 S CARTER RD, LAKELAND, FL 33813-3781
(863) 648-4600
Mailing address
6935 S CARTER RD, LAKELAND, FL 33813-3781
(863) 648-4600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH21072
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5100170014
—
FL
Enumeration date
09/25/2006
Last updated
08/22/2020
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