Organization
INNOVATIVERX GULF COAST PHARMACY INC
Active
Other names
InnovativeRx Gulf Coast Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GAZDA (DIRECTOR OF PHARMACY)
(239) 324-9619
Entity
Organization
Contact information
Practice address
1035 COLLIER CENTER WAY STE 2, NAPLES, FL 34110-8474
(239) 324-9619
Mailing address
1035 COLLIER CENTER WAY, SUITE 2, NAPLES, FL 34110-8474
(239) 324-9619
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26491
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5713892
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/25/2013
Last updated
03/25/2013
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