Healthcare Provider Details

I. General information

NPI: 1376880187
Provider Name (Legal Business Name): EUGENE LOUIS PLOCH JR. PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 01/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5991 PINE RIDGE RD
NAPLES FL
34119-3956
US

IV. Provider business mailing address

5991 PINE RIDGE RD
NAPLES FL
34119-3956
US

V. Phone/Fax

Practice location:
  • Phone: 239-352-1484
  • Fax: 239-352-6386
Mailing address:
  • Phone: 239-352-1484
  • Fax: 239-352-6386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS48742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: