| NPI | 1629502141 |
|---|---|
| Doing Business As | LAKE WALES PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GOPIKA TRIVEDI Owner 863-676-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL ph26509) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |