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LAKE PHARMACY INC NPI 1972592889


NPI Information

NPI: 1972592889
Provider Name: LAKE PHARMACY INC
Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
25 MARTIN LUTHER KING JR BLVD
SUITE 3
BELLE GLADE, FL
ZIP 33430
Phone: (561) 996-0200
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LAKE PHARMACY INC is a community/retail pharmacy pharmacy in Belle Glade, FL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. LAKE PHARMACY INC NPI is 1972592889. The provider is registered as an organization entity type.

The provider's business location address is:

25 MARTIN LUTHER KING JR BLVD
SUITE 3
BELLE GLADE, FL
ZIP 33430-044
Phone: (561) 996-0200
Fax: (561) 996-0201

The provider's authorized official is Robert Story .
The authorized official title is Rpa and has the following contact phone number (561) 996-0200.

The enumeration date for this NPI number is 10/14/2005 and was last updated on 8/18/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPH6551FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1105213600MEDICAIDFLORIDA
21033884OTHEROTHER ID NUMBER
3DQ779AMEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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