LAKE WIRE PHARMACY INC (NPI# 1104983899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104983899 |
| Entity Type | Organization |
| Organization Name | LAKE WIRE PHARMACY INC |
| Practice Address |
505 Martin Luther King Jr Ave Suite 3 Lakeland FL 33815 |
| Practice Telephone | 8636826880 |
| Practice Fax Number | 8636880721 |
| Mailing Telephone | 8636826880 |
| Mailing Fax Number | 8636880721 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CHORETTE BENNETT DICKENS (PHARMACY MANAGER) |
| Authorized Official Telephone | 8636826880 |
| Authorized Official Credential | R PH PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 183500000X | Pharmacist | PS18682 | FL | Pharmacy Service Providers |
| X | 333600000X | Pharmacy | PH10343 | FL | Suppliers |
| Street Address |
505 MARTIN LUTHER KING JR AVE SUITE 3 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083936058 | Blake and Franklin Md Pa | General Practice | 505 Martin Luther King Jr Ave, Ste 2, Lakeland, FL 33815 | 2010-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174162093 | Deborah Beall Boynton | Counselor | 219 Hillcrest St, Lakeland, FL 33815 | 2019-12-23 |
| 1992247373 | Lizvel Rosario | Counselor | 220 Lake Wire Dr., Lakeland, FL 33815 | 2016-11-16 |
| 1235554783 | Florida Baptist Children's Homes | Community Based Residential Treatment Facility, Mental Illness | 1015 Sikes Blvd., Lakeland, FL 33815 | 2014-02-20 |
| 1902229255 | Christina Miller | Nurse Practitioner | 6850 New Tampa Hwy Ste 600, Lakeland, FL 33815 | 2014-01-22 |
| 1902111099 | Jeanene Nicole Robinson-kyles | Psychologist | 505 Martin L. King Jr. Ave, Suite 1, Lakeland, FL 33815 | 2010-08-12 |
| 1235287095 | Wendell Owen Blake | Family Medicine | 505 Martin Luther King Ave, Suite 2, Lakeland, FL 33815 | 2007-01-08 |
| 1427038637 | Rotech Oxygen and Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 5315 Great Oak Drive, Lakeland, FL 33815 | 2006-01-23 |
| 1598205841 | Daphne Toussaint | Dentist | 607 S Missouri Ave, Lakeland, FL 33815 | 2017-03-06 |
| 1851398705 | Richard W Merritt Dc Pa | Chiropractor | 1253 W Memorial Blvd, Lakeland, FL 33815-0602 | 2005-07-07 |
| 1093040818 | Rodney W Merritt | Chiropractor | 1253 W Memorial Blvd, Lakeland, FL 33815-0602 | 2009-10-13 |
| Find all providers in zip 33815 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497384085 | Rodjsyne Jones | Pharmacist | 350 Eagles Landing Dr, Lakeland, FL 33810-2999 | 2020-04-06 |
| 1487293445 | Pankaj D Patel | Pharmacist | 3656 Frentress Dr, Lakeland, FL 33812-1206 | 2019-12-22 |
| 1598324436 | Wesley Zane Hamlin | Pharmacist | 1324 Lakeland Hills Blvd # 203, Lakeland, FL 33805-4543 | 2019-06-12 |
| 1518422971 | Prime Therapeutic Consulting & Services, LLC | Pharmacist | 120 W Hickory St, Lakeland, FL 33815-4715 | 2019-02-09 |
| 1982103255 | Robert James Fournier | Pharmacist | 2025 Sylvester Rd Unit J2, Lakeland, FL 33803-3577 | 2018-02-01 |
| 1952846685 | Tara Talisea Guyher | Pharmacist | 2576 Boots Rd, Lakeland, FL 33810-5158 | 2017-01-04 |
| 1003288556 | Casey Ray Hanks | Pharmacist | 12360 Lakeland Acres Rd, Lakeland, FL 33810-1016 | 2015-10-23 |
| 1528430238 | Roshan Nathoo | Pharmacist | 7387 Us Highway 98 N, Lakeland, FL 33809-2102 | 2015-10-21 |
| 1760853832 | Cheryl Adele Minozzi | Pharmacist | 5524 Scott View Ln, Lakeland, FL 33813-3064 | 2015-10-14 |
| 1275912073 | Brent Williams | Pharmacist | 2016 Sophia Pl, Lakeland, FL 33811-2684 | 2015-05-26 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.