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General NPI Number Information
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NPI Number | 1952637449
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Entity Type | Organization
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Legal Business Name | J-M WARD ENTERPRISES LLC
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 11/16/2017
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Provider Practice Location Address
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Address Line | 9048 BONITA BEACH RD SE
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4237
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Country | US
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Telephone | 239-221-7233
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Fax | 239-221-7282
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Provider Business Mailing Address
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Address Line | 9048 BONITA BEACH RD SE
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4237
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Country | US
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Telephone | 239-221-7233
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Fax | 239-221-7282
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Authorized Official
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Title or Position | OWNER/ PHARMACY TECH
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Name | JOHN BREWER
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Credential |
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Telephone | 239-221-7233
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH24311
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License Number State | FL
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