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General NPI Number Information
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NPI Number | 1073815783
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Entity Type | Organization
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Legal Business Name | DLKA HOLDINGS, LLC
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 181 SABAL PALM DR STE 101
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City | LONGWOOD
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State | FL
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Zip | 32779-2594
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Country | US
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Telephone | 407-682-3211
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Fax | 407-682-1314
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Provider Business Mailing Address
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Address Line | PO BOX 915726
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City | LONGWOOD
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State | FL
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Zip | 32791-5726
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Country | US
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Telephone | 407-682-3211
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Fax | 407-682-1314
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Authorized Official
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Title or Position | MGRM
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Name | ROBERT S MILLER
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Credential | RPH, CPH
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Telephone | 407-682-3211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH-24338
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License Number State | FL
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