MEDICARE: CHEEK 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH147	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2004026	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760483572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEEK PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 5020
Second Line	:
City	:	CROSS CITY
State	:	FL
Zip	:	32628-5020
Country	:	US
Telephone Number	:	352-498-3342
Fax Number	:	352-498-4111

Provider Business Practice Location Address
First Line	:	16734 SE 19 HWY
Second Line	:
City	:	CROSS CITY
State	:	FL
Zip	:	32628-5020
Country	:	US
Telephone Number	:	352-498-3342
Fax Number	:	352-498-4111

Authorized Official
Title or Position	:	PRES
Name	:	JOHN BOATRIGHT
Credential	:
Telephone Number	:	352-498-3342

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	12/16/2016

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Directions to “CHEEK PHARMACY INC ” Practice Location

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