Pederson, Larry William

Pederson, Larry William is an individual health care provider with primary practice located at 1302 River St , Palatka FL 32177-5042. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Pederson, Larry William can be contacted via phone (386) 328-0558.

Contact Information

Primary practice address
1302 River St Palatka FL 32177-5042
Phone: (386) 328-0558
Fax: (386) 328-9443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PS0015494 Florida
Pharmacy Service Providers / Pharmacist 183500000X PU0002781 Florida

Profile Details

NPI number 1023187101
LBN Legal business name Pederson, Larry William
Credentials R.PH., C.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Mar 6th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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