Organization
CRJ PHARMACY, INC.
Active
Other names
CRJ Neighborhood Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK ORVILLE O'BANNON (PRESIDENT)
(863) 669-1329
Entity
Organization
Contact information
Practice address
1845 N CRYSTAL LAKE DR, LAKELAND, FL 33801-5902
(863) 669-1329
(863) 669-1521
Mailing address
1845 N CRYSTAL LAKE DR, LAKELAND, FL 33801-5902
(863) 669-1329
(863) 669-1521
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PH21511
FL
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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