Organization
PUBLIX
Active
Organization
PUBLIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGIE KING (DISTRICT MANAGER)
(239) 206-7993
Entity
Organization
Contact information
Practice address
4065 HANCOCK BRIDGE PKWY, FORT MYERS, FL 33903-4294
(239) 997-0212
Mailing address
4065 HANCOCK BRIDGE PKWY, NORTH FORT MYERS, FL 33903-4294
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1629017595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS54008
REGISTERED PHARMACIST
FL
Enumeration date
10/07/2015
Last updated
10/07/2015
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