Provider Demographics
NPI:1073815783
Name:DLKA HOLDINGS, LLC
Entity Type:Organization
Organization Name:DLKA HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CPH
Authorized Official - Phone:407-682-3211
Mailing Address - Street 1:PO BOX 915726
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32791-5726
Mailing Address - Country:US
Mailing Address - Phone:407-682-3211
Mailing Address - Fax:407-682-1314
Practice Address - Street 1:181 SABAL PALM DR STE 101
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-2594
Practice Address - Country:US
Practice Address - Phone:407-682-3211
Practice Address - Fax:407-682-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH-24338333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy