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General NPI Number Information
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NPI Number | 1184981656
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Entity Type | Organization
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Legal Business Name | LEE MEMORIAL HEALTH SYSTEM
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 9981 S HEALTHPARK DR
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City | FORT MYERS
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State | FL
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Zip | 33908-3618
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Country | US
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Telephone | 239-343-5100
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Fax | 239-343-5275
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Provider Business Mailing Address
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Address Line | 636 DEL PRADO BLVD S SUITE 4, MOB
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City | CAPE CORAL
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State | FL
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Zip | 33990-2668
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Country | US
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Telephone | 239-424-3157
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | BEN SPENCE
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Credential | PHARMD
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Telephone | 239-343-6014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26244
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License Number State | FL
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