Shadreka T McIntosh, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS39367 Issued in FL

Practice address

3510 Dr Martin Luther King Blvd
Ste 1
Fort Myers, FL 33916-4608

Phone

(239) 826-4192

NPI assigned

Apr 18, 2007

Last updated

Feb 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Total Healthcare Alliance

  dba Sozo Wellness Pharmacy

  • Community/Retail Pharmacy
  • Fort Myers, FL
  • NPI 1487276663
  NPD Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1619194263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3891 BURRFIELD ST",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339168044",
            "telephone_number": "239-826-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 DR MARTIN LUTHER KING BLVD",
            "address_2": "STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339164608",
            "telephone_number": "239-826-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "SHADREKA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael McGrew
• Jason Matthew McGuire, PH.D., CRNA
• Shawn M McGuyrt, NPC
• Eileen M McIltrot, MSW, LCSW
• Letitia A McIntosh-Reid, MS, BCBA
• Martha A McKaig Linnemeyer, CNM
• David J McKay
• Sydne McKechnie, M.D.
• Sarah A McKee, MA
• Michael John McKeever, CRNA

• Pharmacist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.