Organization
JOHN KNOX VILLAGE OF CENTRAL FLORIDA INC
Active
Other names
Oak Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SKELTON (PHARMACY DIRECTOR)
(386) 456-1500
Entity
Organization
Contact information
Practice address
701 MONASTERY RD STE A, ORANGE CITY, FL 32763-6222
(386) 456-1500
(385) 456-1551
Mailing address
701 MONASTERY RD, SUITE A, ORANGE CITY, FL 32763-6222
(386) 456-1500
(385) 456-1551
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28802
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014310400
—
FL
01
—
2149639
PK
—
Enumeration date
01/22/2015
Last updated
09/21/2016
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