Organization

Martin Memorial Physician Corporation, Inc

May also be knows as Mhpg Tradition Pharmacy At Martin Health

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

Legal Business Name

Martin Memorial Physician Corporation, Inc

Also Known As

Mhpg Tradition Pharmacy At Martin Health

NPI Number

1407365513

NPI Type

Organization

Enumeration Date

09/21/2017

Specialties

(Taxonomies)

Code

3336C0003X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PH30943

Contact
Information

Purpose

Mailing
Location

Address

10080 SW INNOVATION WAY STE 102
10080 SW INNOVATION WAY STE 102

City

Port St Lucie
Port St Lucie

State

FL
FL

Postal Code

34987-2129
34987-2129

Country

US
US

Telephone Number

(772) 345-8166
(772) 345-8166

Authorized Official

Name

Timothy Longville

Title or Position

CHIEF ACCOUNTING OFFICER/CONTROLLER

Telephone Number

(216) 636-7416

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

Data last updated by provider on 12/08/2022

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