Provider Demographics
NPI:1083908156
Name:HOGREFE, GARY R (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:R
Last Name:HOGREFE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:636 DEL PRADO BLVD
Mailing Address - Street 2:LMHS HEALTH PLAN PHARMACY
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909
Mailing Address - Country:US
Mailing Address - Phone:239-424-2477
Mailing Address - Fax:239-424-4087
Practice Address - Street 1:636 DEL PRADO BLVD
Practice Address - Street 2:LMHS HEALTH PLAN PHARMACY
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909
Practice Address - Country:US
Practice Address - Phone:239-424-2477
Practice Address - Fax:239-424-4087
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist