Big Lake Pharmacy Inc
Organization Active NPI Long Term Care Pharmacy · Okeechobee, FL
NPI 1023098803 · NPPES record last updated Oct 9, 2009
Key facts
- NPI
- 1023098803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Pharmacy 3336L0003X
- License
- PH18708 (FL)
- Legal business name
- BIG LAKE PHARMACY INC
- Practice address
- 203 SW Park St
Ste B
Okeechobee, FL 34972-4160 - Phone
- (863) 763-1339
- Fax
- (863) 763-1487
- NPI assigned
- Jan 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Steven Nelson, RPH/CPH
- Title
- Ceo/Pres
- Phone
- (863) 634-4002
National Provider Directory
Locations
203 SW Park St
Ste B
Okeechobee, FL 34972
Phone (863) 763-1339
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Institutional Pharmacy | 3336I0012X | |||
| Long Term Care Pharmacy | 3336L0003X | PH18708 | FL | Yes |
| Managed Care Organization Pharmacy | 3336M0003X |
Addresses
Primary practice location
203 SW Park St
Ste B
Okeechobee, FL 34972-4160
Mailing address
203 SW Park St
Ste B
Okeechobee, FL 34972-4160
Phone (863) 763-1339
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031557500 | Medicaid | FL | |
| 1096785 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- BIG LAKE PHARMACY
Other providers in Okeechobee, FL
- Big Lake Chiropractic
- Big Lake Eye Care LLC
- Big Lake Home Health Services of Glade County, Inc
- Big Lake Home Health Services, Inc
- Big Lake Kidney Center LLC
- Big Water Emergency Physicians, LLC
- Christine Brennan Bishop
- James Robert Black
- Dawn Arnieze Blount
- Blue Ocean Dermatology LLC
All providers in Okeechobee, FL · Long Term Care Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.