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General NPI Number Information
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NPI Number | 1598678732
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Entity Type | Organization
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Legal Business Name | EAGLE PHARMACY LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 330 EAGLES LANDING DR STE 280
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City | LAKELAND
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State | FL
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Zip | 33810-3041
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Country | US
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Telephone | 855-748-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 350 EAGLES LANDING DR
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City | LAKELAND
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State | FL
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Zip | 33810-2999
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Country | US
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Telephone | 855-748-2663
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Fax |
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Authorized Official
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Title or Position | CPS, PRESIDENT
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Name | MR. HENRY BURGESS III
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Credential |
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Telephone | 919-627-1053
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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 | NULL
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Taxonomy #2
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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 | NULL
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