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REVIVE PHARMACY INC NPI 1558610527


NPI Information

NPI: 1558610527
Provider Name: REVIVE PHARMACY INC

Doing Business As: REVIVE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
16205 S TAMIAMI TRL
SUITE # 6
FORT MYERS, FL
ZIP 33908
Phone: (239) 204-4223
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REVIVE PHARMACY INC is a community/retail pharmacy pharmacy in Fort Myers, FL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. REVIVE PHARMACY INC NPI is 1558610527. The provider is registered as an organization entity type.
The provider Is Doing Business As Revive Pharmacy.

The provider's business location address is:

16205 S TAMIAMI TRL
SUITE # 6
FORT MYERS, FL
ZIP 33908-304
Phone: (239) 204-4223
Fax: (239) 204-4224

The provider's authorized official is Nicole Deforte .
The authorized official title is Owner and has the following contact phone number (239) 204-4223.

The enumeration date for this NPI number is 9/5/2012 and was last updated on 2/26/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPH26342FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12136822OTHERPK
2006790300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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