Organization
LAKE HOLIDAY DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE COFFER (3RD PARTY COORD)
(219) 987-6468
Entity
Organization
Contact information
Practice address
10064 N 600 E, DEMOTTE, IN 46310-8536
(219) 345-2200
(219) 345-2411
Mailing address
PO BOX 662, 915 S HALLECK, DEMOTTE, IN 46310-0662
(219) 987-6468
(219) 987-7226
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
07/21/2006
Last updated
04/04/2018
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