MEDICARE: MRS. MARGARET G KING R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS22685	FL

General Provider Information

NPI Number	:	1023355633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET G KING R.PH.

Provider Business Mailing Address
First Line	:	20321 SUMMERLIN ROAD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908
Country	:	US
Telephone Number	:	239-454-0145
Fax Number	:	863-616-5049

Provider Business Practice Location Address
First Line	:	20321 SUMMERLIN RD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3706
Country	:	US
Telephone Number	:	239-454-0145
Fax Number	:	863-616-5049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	01/16/2013

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