DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BIG LAKE PHARMACY INC

MEDICARE: BIG LAKE PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336I0012XInstitutional Pharmacy
23336M0003XManaged Care Organization Pharmacy
33336L0003XLong Term Care PharmacyPH18708FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21096785OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023098803
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIG LAKE PHARMACY INC
Provider Business Mailing Address
First Line : 203 SW PARK ST
Second Line : STE B
City : OKEECHOBEE
State : FL
Zip : 34972-4160
Country : US
Telephone Number : 863-763-1339
Fax Number : 863-763-1487
Provider Business Practice Location Address
First Line : 203 SW PARK ST
Second Line : STE B
City : OKEECHOBEE
State : FL
Zip : 34972-4160
Country : US
Telephone Number : 863-763-1339
Fax Number : 863-763-1487
Authorized Official
Title or Position : CEO/PRES
Name : STEVEN NELSON
Credential : RPH/CPH
Telephone Number : 863-634-4002
Provider Enumeration Date : 01/18/2006
Last Update Date : 10/09/2009

Similar Medicare Providers

1063419372 — S A S B INC
Practice Location Address:
203 SW PARK ST
OKEECHOBEE, FL
34972-4160
Practice Phone: 863-763-5100
Practice Fax: 863-763-7550
1093712051 — MR. STEVEN DAVID NELSON RPH / CPH
Practice Location Address:
203 SW PARK ST
OKEECHOBEE, FL
34972-4160
Practice Phone: 863-763-5100
Practice Fax: 863-763-8856
1316028053 — S A S B INC
Practice Location Address:
203 SW PARK ST
OKEECHOBEE, FL
34972-4160
Practice Phone: 863-763-5100
Practice Fax: 863-763-7550
1225479579 — MRS. ANDREA MICHELLE NELSON
Practice Location Address:
203 SW PARK ST
OKEECHOBEE, FL
34972-4160
Practice Phone: 863-763-5100
Practice Fax: 863-763-8556
1912328048 — S.A.S.B. INC
Practice Location Address:
203 SW PARK ST
OKEECHOBEE, FL
34972-4160
Practice Phone: 863-763-5100
Practice Fax: 863-763-7550
1356202535 — LEANNA CONVERTINI
Practice Location Address:
510 N PARROTT AVE
OKEECHOBEE, FL
34972-2645
Practice Phone: 863-824-3480
Practice Fax:

Directions to “BIG LAKE PHARMACY INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.