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Organization

GULF COAST MEDICAL PHARMACY INC

Active
Parent organization
GULF COAST MEDICAL PHARMACY INC
Other names
GULF COAST MEDICAL PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
GULF COAST MEDICAL PHARMACY INC
Authorized official
MR. JEFFREY R. GREEN (OWNER)
(239) 278-3969
Entity
Organization

Contact information

Practice address
13685 DOCTORS WAY, SUITE #150, FORT MYERS, FL 33912-4336
(239) 278-3969
(239) 278-0336
Mailing address
13685 DOCTORS WAY, SUITE #150, FT.MYERS, FL 33912
(239) 278-3969
(239) 278-0336

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PH20076
FL

Other

Enumeration date
11/16/2006
Last updated
12/09/2009
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