Provider Demographics
NPI:1740375393
Name:THE MEDICINE CHEST, INC
Entity type:Organization
Organization Name:THE MEDICINE CHEST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:954-325-2850
Mailing Address - Street 1:910 OLD CAMP RD
Mailing Address - Street 2:BUILDING #170
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5604
Mailing Address - Country:US
Mailing Address - Phone:352-753-1877
Mailing Address - Fax:352-753-3755
Practice Address - Street 1:910 OLD CAMP RD
Practice Address - Street 2:BUILDING #170
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5604
Practice Address - Country:US
Practice Address - Phone:352-753-1877
Practice Address - Fax:352-753-3755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH0016588333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1052884OtherNABP NUMBER
FL1052884OtherNABP NUMBER
FL1052884OtherNABP NUMBER