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General NPI Number Information
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NPI Number | 1588950414
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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 | 06/20/2011
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Last Update Date | 12/30/2012
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Provider Practice Location Address
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Address Line | 1361 E OSCEOLA PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-1605
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Country | US
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Telephone | 407-288-8836
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Fax | 407-846-0111
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Provider Business Mailing Address
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Address Line | 1361 E OSCEOLA PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-1605
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Country | US
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Telephone | 407-288-8836
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Fax | 407-846-0111
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Authorized Official
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Title or Position | XXXXXXXXXXXXXXXX
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Name | MR. XXXXXXXXXXX XXXXXXXX
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Credential |
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Telephone | 407-288-8836
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH24338
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License Number State | FL
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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 | PH24338
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License Number State | FL
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