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General NPI Number Information
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NPI Number | 1780210179
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Entity Type | Organization
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Legal Business Name | SEWALL'S POINT PHARMACY INC
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Dates
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Enumeration Date | 03/17/2020
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Last Update Date | 02/06/2021
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Provider Practice Location Address
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Address Line | 3754 SE OCEAN BLVD STE B
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City | STUART
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State | FL
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Zip | 34996-6700
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Country | US
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Telephone | 726-008-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 3754 SE OCEAN BLVD STE B
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City | STUART
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State | FL
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Zip | 34996-6700
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Country | US
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Telephone | 772-600-8077
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Fax | 772-600-5576
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRISTAL TOTTERMAN
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Credential | PHARMD
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Telephone | 772-600-8077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 |
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License Number State |
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