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General NPI Number Information
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NPI Number | 1588414049
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Entity Type | Organization
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Legal Business Name | INDIAN RIVER MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 1000 36TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-4862
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Country | US
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Telephone | 772-290-6970
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Fax | 772-290-6971
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Provider Business Mailing Address
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Address Line | 1000 36TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-4862
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Country | US
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Telephone | 772-290-6970
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Fax | 772-290-6971
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | CHARLES ANDREW GOWANS
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Credential | R.PH
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Telephone | 754-243-4121
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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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