| NPI | 1043763139 |
|---|---|
| Doing Business As | CENTRAL FLORIDA HEALTH CARE PHARMACY LAKE WALES |
| Entity Type | Organization |
| Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2019-09-12 |