| NPI | 1467517888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILL CLAY Owner 209-463-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: CA PHY37064) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-08-22 |