Organization
TOTAL HEALTHCARE ALLIANCE
Active
Organization
TOTAL HEALTHCARE ALLIANCE
Active
Other names
SOZO WELLNESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHADREKA MCINTOSH PHARM.D. (OWNER)
(239) 488-2580
Entity
Organization
Contact information
Practice address
3510 DR MARTIN LUTHER KING BLVD STE 1, FORT MYERS, FL 33916-4608
(239) 826-4192
Mailing address
3510 DR MARTIN LUTHER KING BLVD STE 1, FORT MYERS, FL 33916-4608
(239) 488-2580
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108203100
—
FL
Enumeration date
05/11/2020
Last updated
02/25/2022
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