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General NPI Number Information
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NPI Number | 1083966105
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Entity Type | Organization
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Legal Business Name | JC RESOURCES LLC
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 689 9TH ST N
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City | NAPLES
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State | FL
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Zip | 34102-8100
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Country | US
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Telephone | 239-262-2222
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Fax | 239-262-8943
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Provider Business Mailing Address
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Address Line | 689 9TH ST N
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City | NAPLES
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State | FL
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Zip | 34102-8100
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Country | US
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Telephone | 239-262-2222
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Fax | 239-262-8943
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER HERWIG
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Credential |
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Telephone | 239-514-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26516
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License Number State | FL
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