Organization

Clover Pharmacy Inc

May also be knows as Clover Pharmacy Inc

Community/Retail Pharmacy in Port St Lucie, FL(View on Map)

Legal Business Name

Clover Pharmacy Inc

Also Known As

Clover Pharmacy Inc

NPI Number

1548650088

NPI Type

Organization

Enumeration Date

02/04/2015

Specialties

(Taxonomies)

Code

3336C0003X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PH28830

Contact
Information

Purpose

Mailing
Location

Address

259-357 SE PORT ST LUCIE BLVD
259-357 SE PORT ST LUCIE BLVD

City

Port St Lucie
Port St Lucie

State

FL
FL

Postal Code

34952
34952

Country

US
US

Telephone Number

(772) 333-2585
(772) 333-2585

Authorized Official

Name

Miguel Ravelo

Title or Position

OWNER

Telephone Number

(772) 206-5054

Identifiers

Identifier

2149942

Identifier State

Unknown

Identifier Issuer

PK

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/04/2015

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