Organization
GULF MED PHARMACY INC
Active
Other names
GULF MED PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
GUERDITH FERTIL (PRESIDENT/OWNER)
(239) 541-9789
Entity
Organization
Contact information
Practice address
4106 DEL PRADO BLVD S, CAPE CORAL, FL 33904-7163
(239) 542-1291
(239) 542-1292
Mailing address
4106 DEL PRADO BLVD S, CAPE CORAL, FL 33904-7163
(239) 542-1291
(239) 542-1292
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30406
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158420
PK
—
Enumeration date
02/25/2016
Last updated
12/18/2016
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