Healthcare Provider Details

I. General information

NPI: 1730520503
Provider Name (Legal Business Name): HILLCREST PROPERTIES VII INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 9TH ST N
NAPLES FL
34102-5806
US

IV. Provider business mailing address

421 9TH ST N
NAPLES FL
34102-5806
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-2929
  • Fax: 239-262-3058
Mailing address:
  • Phone: 239-262-2929
  • Fax: 239-262-3058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number19205
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL WHITTENHALL
Title or Position: DIRECTOR
Credential:
Phone: 239-572-0819