# FREDERICA PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Frederica Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720741564
- **Authorized official:** DR. MELISSA F LUCE PHARMD (VICE PRESIDENT)
- **Authorized official phone:** (912) 357-2357

## Contact information

- **Practice address:** 3603 FREDERICA RD, SAINT SIMONS ISLAND, GA 31522-1334
- **Practice address phone:** (912) 357-2357
- **Mailing address:** 3603 FREDERICA RD, SAINT SIMONS ISLAND, GA 31522-1334
- **Mailing address phone:** (912) 357-2357
- **Mailing address fax:** (888) 626-5910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/19/2021
- **Last updated:** 05/22/2025