| NPI | 1528195393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT HENNES Student Health Center Director 209-667-3396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: CA CLE1147) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHE19595) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-02-19 |