Organization
FREDERICA PHARMACY INC.
Active
Other names
Frederica Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA F LUCE PHARMD (VICE PRESIDENT)
(912) 357-2357
Entity
Organization
Contact information
Practice address
3603 FREDERICA RD, SAINT SIMONS ISLAND, GA 31522-1334
(912) 357-2357
Mailing address
3603 FREDERICA RD, SAINT SIMONS ISLAND, GA 31522-1334
(912) 357-2357
(888) 626-5910
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003263426A
—
GA
Enumeration date
10/19/2021
Last updated
05/22/2025
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