Organization
MARCO ISLAND PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HIEP PHAM (PRESIDENT, OWNER)
(239) 970-2490
Entity
Organization
Contact information
Practice address
905 N COLLIER BLVD, MARCO ISLAND, FL 34145-2742
(239) 970-2490
(239) 970-2761
Mailing address
905 N COLLIER BLVD, MARCO ISLAND, FL 34145-2742
(239) 970-2490
(239) 970-2761
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH29521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH29521
BOARD OF PHARMACY LICENSE
FL
Enumeration date
11/11/2015
Last updated
06/26/2017
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