Gulf Med Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH30406 Issued in FL

Legal business name

GULF MED PHARMACY INC

Doing business as

Gulf Med Pharmacy Inc

Practice address

4106 Del Prado Blvd S
Cape Coral, FL 33904-7163

Phone

(239) 542-1291

Fax

(239) 542-1292

NPI assigned

Feb 25, 2016

Last updated

Dec 18, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Guerdith Fertil

Title

President/Owner

Phone

(239) 541-9789

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• GULF MED PHARMACY INC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482019200000",
    "number": "1538529060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047163",
            "telephone_number": "239-542-1291",
            "fax_number": "239-542-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047163",
            "telephone_number": "239-542-1291",
            "fax_number": "239-542-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF MED PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-12-18",
        "status": "A",
        "authorized_official_last_name": "FERTIL",
        "authorized_official_first_name": "GUERDITH",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "239-541-9789"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH30406",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158420",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GULF MED PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kristin Ann Gustin, APRN

• Community/Retail Pharmacy in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.