Healthcare Provider Details

I. General information

NPI: 1215073820
Provider Name (Legal Business Name): CDS PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10061 AMBERWOOD RD
FORT MYERS FL
33913-8502
US

IV. Provider business mailing address

10061 AMBERWOOD RD
FORT MYERS FL
33913-8502
US

V. Phone/Fax

Practice location:
  • Phone: 239-415-3309
  • Fax: 239-433-5518
Mailing address:
  • Phone: 239-415-3309
  • Fax: 239-433-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22487
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL HAMILTON
Title or Position: VP PHARMACIST
Credential: BS PHARM PHARM D RPH
Phone: 239-415-3309