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1518338722
CHARLES M TIDWELL
RIVERSIDE, CA
NPI
1518338722
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Entity Type
Organization
Authorized Contact
CHARLES MICHAEL TIDWELL
Pharmacist
951-637-7054
Organization Subpart ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: CA 38762)
Enumeration Date
2015-10-14
Last Update Date
2015-10-14
Business Address
CHARLES M TIDWELL
3975 JACKSON ST STE 111
RIVERSIDE, CA 92503-3946
Phone number: 951-637-7054
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Mailing Address
CHARLES M TIDWELL
3975 JACKSON ST STE 111
RIVERSIDE, CA 92503-3946
Phone number: 951-637-7054
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