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Tommy L Louisville Md Pa
Non-Pharmacy Dispensing Site in Lakeland, Florida
NPI 1295143295

Tommy L Louisville Md Pa is a Non-Pharmacy Dispensing Site based in San Diego, FL. Tommy L Louisville Md Pa practices in Lakeland, FL. The NPI Number for Tommy L Louisville Md Pa is 1295143295 and holds a License No. ME46305 (Florida).

The current practice location address for Tommy L Louisville Md Pa is 1801 Crystal Lake Dr, Lakeland, FL and can be reached out via phone at 863-937-8886. You can also correspond with Tommy L Louisville Md Pa through the mailing address at 5626 OBERLIN DR, SAN DIEGO, CA - 92121-1705 (mailing address contact number: ).

Location: 1801 Crystal Lake Dr, Lakeland, FL, 92121-1705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295143295
Provider Name
Tommy L Louisville Md Pa
Credential
Provider Entity Type
Organization
Address
1801 Crystal Lake Dr, Lakeland, FL, 92121-1705
Phone Number
863-937-8886
Fax Number
Provider Enumeration Date
07/23/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1801 Crystal Lake Dr
City
Lakeland
State
Florida
Zip
33801-5979
Phone Number
863-937-8886
Fax Number
person
Provider Business Mailing Address Details
Address
5626 Oberlin Dr
City
San Diego
State
California
Zip
92121-1705
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
ME46305 (Florida)
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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