Liddy'S Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH19502 Issued in FL

Legal business name

LIDDY'S PHARMACY, LLC

Doing business as

Synergy Pharmacy

Practice address

4204 S Florida Ave Ste E
Lakeland, FL 33813-1669

Phone

(863) 647-9899

Fax

(863) 709-0030

NPI assigned

Jul 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Melinda Liddy

Title

Owner

Phone

(863) 647-9899

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Synergy Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1073547287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 S FLORIDA AVE STE E",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131669",
            "telephone_number": "863-647-9899",
            "fax_number": "863-709-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 S FLORIDA AVE STE E",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131669",
            "telephone_number": "863-647-9899",
            "fax_number": "863-709-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDDY'S PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "LIDDY",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-647-9899",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH19502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1012171",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.