Provider Demographics
NPI:1083004378
Name:SHAMROCK DRUGS, LLC
Entity Type:Organization
Organization Name:SHAMROCK DRUGS, LLC
Other - Org Name:SHAMROCK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SIMS-MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-659-4744
Mailing Address - Street 1:6 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-9622
Mailing Address - Country:US
Mailing Address - Phone:863-659-4744
Mailing Address - Fax:888-741-7969
Practice Address - Street 1:6 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-9622
Practice Address - Country:US
Practice Address - Phone:863-659-4744
Practice Address - Fax:888-741-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH288333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy