| NPI | 1619203841 |
|---|---|
| Doing Business As | FRUITVALE AVENUE PHARMACY INC |
| Entity Type | Organization |
| Authorized Contact | KALPESH PATEL Pharmacist/Owner 510-406-3089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 50064) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2015-07-17 |