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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1831879451 |
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| LBN Legal business name | FOUNTAIN LAKE FAMILY PHARMACY LLC | ||||
| Authorized official | MICHAEL BUTLER - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/19/2023 | ||||
| Last updated | 07/19/2023 - About 3 years ago | ||||
| Identifiers |
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FOUNTAIN LAKE FAMILY PHARMACY LLC