FORT MYERS PHARMACY (2753)    INSTITUTION (4)

Name Value
NAME FORT MYERS PHARMACY
STATE FLORIDA
STREET ADDR. 1 3033 Winkler Avenue Extension
CITY Fort Myers
ZIP 33916-9413
OFFICIAL VA NAME Fort Myers Pharmacy
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME FORT MYERS VA CBOC PHARMACY
ST. ADDR. 1 (MAILING) 3033 Winkler Avenue Extension
CITY (MAILING) Fort Myers
STATE (MAILING) FLORIDA
ZIP (MAILING) 33916-9413
EFFECTIVE DATE/TIME
  • 2006-08-22 00:00:00
    STATUS:   ACTIVE
    NPI:   1003874942
TAXONOMY CODE
  • Suppliers
    PRIMARY CODE:   YES
    STATUS:   ACTIVE
LOCATION TIMEZONE EASTERN
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1003874942