Lake Placid Drug Co.
Pharmacist in Lake Placid, FL. Organization (NPI-2).
NPI number1790784346
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1790784346
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Placid Drug Co.
- Organization subpart
- No
- Enumeration date
- Jul 16, 2005
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | PH659 | FL | Yes |
Practice location
224 E Interlake BlvdLake Placid, FL 33852-9603
Phone 863-465-2751 · Fax 863-465-3977
Mailing address
224 E Interlake BlvdLake Placid, FL 33852-9603
Fax 863-465-3977
Authorized official
Charles D. Stidham
Owner/Pharmacist
8634652291
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