Organization · Type 2 NPI

Shands at Lake Shore Inc

Pharmacy · Lake City, FL

NPI number 1366538175 Active

Practice location

368 NE Franklin St
Lake City, FL 32055-3088

Call (386) 754-8000 Map

Fax (352) 733-0069

Mailing address

720 SW 2nd Ave, Suite 360C
Gainesville, FL 32601-6271

Specialties and licenses

Taxonomy	Code	License
Pharmacy Primary	333600000X	4258 (FL)

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

15 other providers at this address

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NPI record

NPI: 1366538175
Entity type: Organization (Type 2)
Issued: Oct 5, 2006
Last updated: Nov 20, 2007
Status: Active
Subpart: Yes of Shands at Lake Shore Inc

Other names

<unavail>
Shands Lake Shore Durable Medical Equipment · other name

Authorized official

Ms. Jodi Mansfield
Sr. Vice President & COO
(352) 265-0440

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366538175

Shands at Lake Shore Inc's National Provider Identifier is 1366538175, issued on Oct 5, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Lake City, FL. The record was last updated on Nov 20, 2007.