Provider Demographics
NPI:1760483572
Name:CHEEK PHARMACY INC
Entity Type:Organization
Organization Name:CHEEK PHARMACY INC
Other - Org Name:CHEEK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-498-3342
Mailing Address - Street 1:PO BOX 5020
Mailing Address - Street 2:
Mailing Address - City:CROSS CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32628-5020
Mailing Address - Country:US
Mailing Address - Phone:352-498-3342
Mailing Address - Fax:352-498-4111
Practice Address - Street 1:16734 SE 19 HWY
Practice Address - Street 2:
Practice Address - City:CROSS CITY
Practice Address - State:FL
Practice Address - Zip Code:32628-5020
Practice Address - Country:US
Practice Address - Phone:352-498-3342
Practice Address - Fax:352-498-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH1473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2004026OtherPK
FL100830700Medicaid