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General NPI Number Information
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NPI Number | 1245797554
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Entity Type | Organization
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Legal Business Name | GATEWAY DRUGS PLLC
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Dates
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Enumeration Date | 02/22/2019
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 12401 COMMERCE LAKES DR STE 3
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City | FORT MYERS
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State | FL
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Zip | 33913-8663
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Country | US
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Telephone | 239-768-1222
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Fax | 239-315-7939
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Provider Business Mailing Address
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Address Line | 12401 COMMERCE LAKES DR STE 3
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City | FORT MYERS
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State | FL
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Zip | 33913-8663
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Country | US
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Telephone | 239-768-1222
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Fax | 239-315-7939
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLEN ELAYNE DANLEY
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Credential | PHARMD
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Telephone | 239-789-7784
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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 |
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License Number State |
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