Healthcare Provider Details

I. General information

NPI: 1780504829
Provider Name (Legal Business Name): DRURY PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19928 CASA VERDE WAY
ESTERO FL
33967-0517
US

IV. Provider business mailing address

19928 CASA VERDE WAY
ESTERO FL
33967-0517
US

V. Phone/Fax

Practice location:
  • Phone: 215-237-6551
  • Fax:
Mailing address:
  • Phone: 215-237-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EILEEN DRURY
Title or Position: MANAGER
Credential: CRNP
Phone: 215-237-6551