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General NPI Number Information
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NPI Number | 1841537826
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Entity Type | Organization
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Legal Business Name | FORT MYERS BEACH PHARMACY
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Dates
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Enumeration Date | 01/10/2013
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 1003 8TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-7709
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Country | US
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Telephone | 941-794-2444
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Fax | 941-794-2446
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Provider Business Mailing Address
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Address Line | 1003 8TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-7709
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Country | US
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Telephone | 941-794-2444
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Fax | 941-794-2446
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Authorized Official
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Title or Position | PRESCRIPTION DEPARTMENT MANAGER
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Name | ROBIN PADGETT
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Credential | PHARMD
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Telephone | 941-794-2444
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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 | PH26595
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License Number State | FL
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