Apothecary Shop

Organization Active NPI Community/Retail Pharmacy · Lake Wales, FL

NPI 1720093339 · NPPES record last updated Mar 26, 2008

Key facts

NPI
1720093339
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
APOTHECARY SHOP
Practice address
437 S 11TH St
Lake Wales, FL 33853-4250
Phone
(863) 676-1174
Fax
(863) 676-5830
NPI assigned
Jul 30, 2006
Organization subpart
No

Authorized official

Name
James Williams
Title
Pharmacist Owner
Phone
(863) 676-1174

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH006754 FL
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

437 S 11TH St
Lake Wales, FL 33853-4250

Mailing address

437 S 11TH St
Lake Wales, FL 33853-4250

Other identifiers

IdentifierTypeStateIssuer
P3131OtherFLBCBS OF FLORIDA
1013553OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other providers in Lake Wales, FL

All providers in Lake Wales, FL · Community/Retail Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.