Organization
INNOVATIVERX GULF COAST PHARMACY INC
Active
Other names
InnovativeRx Gulf Coast Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MACNEAL (PRESIDENT)
(727) 631-9140
Entity
Organization
Contact information
Practice address
1035 COLLIER CENTER WAY STE 2, NAPLES, FL 34110-8474
(239) 324-9619
(239) 280-1226
Mailing address
8222 118TH AVE, SUITE 605, LARGO, FL 33773-5053
(239) 324-9619
(239) 280-1226
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH26348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136766
PK
—
Enumeration date
09/06/2012
Last updated
11/14/2014
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