Provider Demographics
NPI:1245003250
Name:STARKE FAMILY PHARMACY
Entity type:Organization
Organization Name:STARKE FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESCRIPTION DEPARTMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:CHOUDARY
Authorized Official - Last Name:PALADUGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-454-1484
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-0212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 S ORANGE ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-3833
Practice Address - Country:US
Practice Address - Phone:904-454-1484
Practice Address - Fax:800-357-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy