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General NPI Number Information
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NPI Number | 1326839325
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Entity Type | Organization
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Legal Business Name | LAKELAND COMMUNITY PHARMACY LLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 2430 US HIGHWAY 92 E
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City | LAKELAND
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State | FL
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Zip | 33801-2650
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Country | US
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Telephone | 863-333-1111
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Fax | 866-991-4552
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Provider Business Mailing Address
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Address Line | 4040 SUNSET LAKE DR
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City | LAKELAND
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State | FL
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Zip | 33810-2841
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Country | US
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Telephone | 201-916-7123
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Fax | 866-991-4552
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Authorized Official
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Title or Position | MEMBER
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Name | SAMIR DHADUK
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Credential |
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Telephone | 201-916-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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