| NPI | 1417483389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS H HOWARD Pharmacy Manager 209-857-4778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY55632) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-02-28 |