| NPI | 1295829638 |
|---|---|
| Doing Business As | LAKE PHARMACY- TAVARES |
| Entity Type | Organization |
| Authorized Contact | GEORGE W WARREN President 352-357-4341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH 15795) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-03-07 |